[Useful treatment modality for postoperative duodenal fistula with somatostatin analogue]

A case with leakage of duodenal stump treated by a somatostatin analogue (SMS 201-995,SMS) effectively was reported. A 39-year-old man had underwent gastric resection (Billroth I) and distal pancreaticojejunostomy for transsection of duodenal bulbus and pancreatic body. After 14 days later duodenal diverticulization was performed due to anastomotic stricture of the gastro-duodenostomy, which resulted in leakage of duodenal stump and voluminous fluids from drains were lasting about 5 weeks. Amylase (AMY) value was shown as high as 703,812 U/l in the exudate. SMS was injected by 100 micrograms, s, c, by three times a day for 24 days. The volume of exudate decreased immediately after the administration of SMS and to one-half in volume in 2 weeks. AMY also fell to 42, 378 U/l. The drain was removed two months after the third surgery. The patient was discharged on post operative day 200. SMS was known to inhibit secretion of bile and intestinal as well as pancreatic juice and its usefulness for leakage of the intestinal tract, especially of the duodenum, is suggested.