To evaluate the clinical efficacy of octreotide in preventing pancreatic fistula after pancreaticoduodenectomy (PD).

Clinical data of 134 patients undergoing PD in the Third Affiliated Hospital of Sun Yat-sen University from January 2017 to January 2020 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. Among them, 83 patients were male and 51 female, aged (57±11) years on average. The diameter of pancreatic duct <3 mm and soft texture of pancreas were regarded as high-risk factors for the postoperative pancreatic fistula, by which patients were divided into low-risk (n=64) and high-risk groups (n=70). In each group, patients were further divided into the octreotide and non-octreotide subgroups according to whether octreotide was used. The incidence of postoperative pancreatic fistula was observed and compared by Chi-square test or Fisher's exact test.

The incidence of pancreatic fistula was 19%(25/134). The incidence of pancreatic fistula in the low-risk group was 11%(7/64), significantly lower than 26%(18/70) in the high-risk group (χ2=4.810, P<0.05). The incidence of pancreatic fistula in the high-risk, octreotide subgroup was 11%(4/35), significantly lower than 40%(14/35) in the high-risk, non-octreotide subgroup (χ2=7.479, P<0.05). The incidence of postoperative pancreatic fistula in the low-risk, octreotide subgroup and low-risk non-octreotide subgroup was 9%(3/32) and 13%(4/32), respectively, where no significant difference was observed (P=1.000).

The risk of pancreatic fistula after PD can be evaluated according to the pancreatic tissues. Octreotide can reduce the risk of pancreatic fistula in high-risk patients, whereas it exerts no effect upon low-risk patients.