1.Successful Treatment of Enterocutaneous Fistula in a Hemodialysis Patient with Somatostatin.
Ahmet Alper KIYKIM ; Bulent UYAR ; Tuna KATIRCIBASI ; Koray OCAL ; Altan YILDIZ ; Caner OZER
Yonsei Medical Journal 2009;50(6):865-866
Although cysticercosis is the most common parasitic disease affecting the central nervous system, spinal cysticercosis is rare. A rare form of spinal cysticercosis involving the whole spinal canal is presented. A 45-year-old Korean male had a history of intracranial cysticercosis and showed progressive paraparesis. Spinal magnetic resonance scan showed multiple cysts compressing the spinal cord from C1 to L1. Three different levels (C1-2, T1-3, and T11-L1) required operation. Histopathological examination confirmed cysticercosis. The patient improved markedly after surgery.
Adult
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Female
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Hormones/adverse effects/*therapeutic use
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Humans
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Intestinal Fistula/*drug therapy/etiology
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Male
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Middle Aged
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Renal Dialysis/*adverse effects
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Somatostatin/adverse effects/*therapeutic use
2.Clinical effect and safety of somatostatin in treatment of postoperative gastrointestinal bleeding in neonates.
Bo-Xiang QI ; Lei ZHU ; Lei SHANG ; Li-Ping SHENG ; Bao-Li HU ; Kun GAO
Chinese Journal of Contemporary Pediatrics 2016;18(11):1065-1068
OBJECTIVETo investigate the clinical effect and safety of somatostatin in the treatment of postoperative gastrointestinal bleeding in neonates.
METHODSA prospective randomized study was performed, and 126 neonates who underwent surgery for congenital gastrointestinal anomalies were randomly divided into control group, treatment group A, and treatment group B. The neonates in the control group were given routine postoperative hemostasis, and those in the treatment groups were given somatostatin in addition to the treatment for the control group. The neonates in treatment group A were given intravenous injection of somatostatin 0.25 mg as the initial dose and 0.25 mg/h for maintenance, and those in treatment group B were given continuous intravenous pumping of somatostatin at a dose of 3.5 μg/(kg·h). The clinical outcome and complications were compared between the three groups.
RESULTSCompared with the control group, the treatment groups had significantly shortened clearance time in occult blood test for gastrointestinal decompression drainage and a significantly lower degree of the reduction in 24-hour hemoglobin (P<0.05), while there were no significant differences between treatment groups A and B. Compared with the control group, treatment group A had significant reductions in heart rate (HR), respiratory rate (RR), blood pressure (BP), and SaO2 after one hour of treatment (P<0.05 ), but there were no significant differences at the other time points between the two groups (P>0.05). There were no significant differences in monitoring indices between the control group and treatment group B (P>0.05). No neonates in the control group experienced hypoglycemia reaction, and treatment group A had a significantly higher incidence rate of hypoglycemia (20%) than treatment group B (P<0.05).
CONCLUSIONSSomatostatin has a marked clinical effect and good safety in the treatment of neonates with postoperative gastrointestinal bleeding, and the administration of somatostatin by continuous intravenous pumping leads to fewer side effects.
Female ; Gastrointestinal Hemorrhage ; drug therapy ; Humans ; Infant, Newborn ; Male ; Postoperative Complications ; drug therapy ; Prospective Studies ; Somatostatin ; adverse effects ; therapeutic use
3.Is prophylactic somatostatin effective to prevent post-endoscopic retrograde cholangiopancreatography pancreatitis or hyperamylasemia? A randomized, placebo-controlled pilot trial.
Zi-kai WANG ; Yun-sheng YANG ; Feng-chun CAI ; Yong-hua WANG ; Xiao-lin SHI ; Chen DING ; Wen LI
Chinese Medical Journal 2013;126(13):2403-2408
BACKGROUNDEffects of prophylactic somatostatin on post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) and hyperamylasemia remain inconclusive. This study aimed to examine whether high-dose, long-term continuous infusion of somatostatin can reduce the incidence of PEP and post-ERCP hyperamylasemia.
METHODSThis was a randomized, placebo-controlled pilot trial. One hundred and twenty-four patients scheduled for ERCP from December 2008 to May 2010 randomly received one of the following three interventions: pre-ERCP somatostatin (0.5 mg/h for 24 hours, starting 1 hour prior to ERCP; n = 36), post-ERCP somatostatin (0.5 mg/h for 24 hours, starting 1 hour after ERCP; n = 47), or placebo (saline for 24 hours, starting 1 hour prior to ERCP; n = 41). Serum amylase and lipase concentrations were measured 1 to 3 hours prior to ERCP and 6, 24, and 48 hours after ERCP.
RESULTSThe three groups did not differ in age, gender, medical history, or ERCP procedure (catheterization using contrast or guidewire, pancreatic duct visualization, procedure time, or procedure type). The rate of PEP was 13.7% (17/124) in the overall study sample and 16.7% (6/36), 10.6% (5/47), and 14.6% (6/41) in the pre-ERCP somatostatin, post-ERCP somatostatin, and placebo groups, respectively (P = 0.715). The rate of post-ERCP hyperamylasemia was 19.4% (7/36), 21.3% (10/47), and 46.3% (19/41) in the pre-ERCP somatostatin, post-ERCP somatostatin, and placebo groups, respectively (P = 0.011).
CONCLUSIONSHigh-dose, long-term continuous infusion (0.5 mg/h for 24 hours) of somatostatin, performed as either a pre- or post-ERCP, can reduce the incidence of hyperamylasemia, but not PEP.
Adult ; Aged ; Cholangiopancreatography, Endoscopic Retrograde ; adverse effects ; Female ; Humans ; Hyperamylasemia ; prevention & control ; Male ; Middle Aged ; Pancreatitis ; prevention & control ; Pilot Projects ; Somatostatin ; therapeutic use
4.Analysis of pancreatic leaking-related risk factors after pancreaticoduodenectomy.
Xin LI ; Ming DONG ; Jian-ping ZHOU ; Yu-ji LI ; Fan-min KONG ; Yu-lin TIAN
Chinese Journal of Surgery 2009;47(10):752-754
OBJECTIVETo analysis the risk factors of pancreatic fistula after pancreaticoduodenectomy (PD).
METHODSA retrospective clinical study had been done in 97 patients who underwent PD between June 2001 and June 2006. The two groups were first compared by the univariate analysis;logistic regression was then used to determine the effect of multiple factors on pancreatic fistula. A P-value of less than 0.05 was considered to be statistically significant.
RESULTSOf the 97 patients, 13 patients were identified as having pancreatic fistula. Factors significantly increasing the risk of pancreatic fistula by univariate analysis included preoperative serum total bilirubin (P = 0.038), operative time (P = 0.003) and whether or not Braun anastomosis (P = 0.034), and prophylactic use of somatostatin (P = 0.003) after operation. A multivariate logistic regression analysis revealed the factors most highly associated with pancreatic fistula to be preoperative serum total bilirubin (OR = 11.687, P = 0.021) and postoperative prophylactic use of somatostatin (OR = 0.056, P = 0.020).
CONCLUSIONSPreoperative serum total bilirubin more than 170 mmol/L was a risk factor of pancreatic fistula after PD, and postoperative prophylactic use of somatostatin was a protect factor of pancreatic fistula after PD.
Adult ; Aged ; Bilirubin ; blood ; Female ; Humans ; Male ; Middle Aged ; Pancreatic Fistula ; etiology ; Pancreaticoduodenectomy ; adverse effects ; Postoperative Complications ; etiology ; Retrospective Studies ; Risk Factors ; Somatostatin ; therapeutic use ; Young Adult
5.Application of somatostatin combined with oral vancomycin in the treatment of intestinal obstruction after liver transplantation.
Chang-Jie CAI ; Min-Ru LI ; Shu-Hong YI ; Gen-Shu WANG ; Min-Qiang LU ; Gui-Hua CHEN
Chinese Journal of Gastrointestinal Surgery 2008;11(4):335-338
OBJECTIVETo investigate the effect of somatostatin combined with oral vancomycin in the treatment of intestinal obstruction after liver transplantation.
METHODSFifty-eight cases of intestinal obstruction after liver transplantation from Jan. 2005 to Dec. 2006 were divided into two groups: Group A (from Jan. 2005 to Dec. 2005) received traditional treatment, including fasting,gastrointestinal decompression, maintaining electrolyte and acid-base balance, enteral and parenteral nutrition support and antibiotics; Group B (from Jan. 2006 to Dec. 2006) received somatostatin combined oral vancomycin in addition to the above mentioned traditional treatment.
RESULTSFifty-eight cases out of 441 patients (13%) suffered from intestinal obstruction after liver transplantation. Group B had a better outcome as compared with Group A, including a quick recovery of flatus and stool, [(7.1+/-2.0) d and (8.4+/-2.4) d vs (9.1+/-3.0) d and (10.8+/-3.4) d] (P<0.05), less amount of gastric drainage [(298+/-58) ml/d vs (485+/-106) ml/d](P<0.05). The rate of intestinal flora imbalance in Group B was 55%, which was significantly less than the 77% in Group A(P<0.05).
CONCLUSIONThe application of somatostatin combined with oral vancomycin can improve the symptoms of intestinal obstruction after liver transplantation and decrease the rate of intestinal flora imbalance.
Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Intestinal Obstruction ; drug therapy ; etiology ; Liver Transplantation ; adverse effects ; Male ; Middle Aged ; Postoperative Complications ; drug therapy ; Somatostatin ; therapeutic use ; Vancomycin ; therapeutic use ; Young Adult