Highlights
- •Partial courses of pasireotide do not increase risk of pancreatic fistula.
- •Single preoperative dosing of pasireotide may be appropriate in low-risk patients.
- •Smoking is associated with pancreatic fistula in patients receiving pasireotide.
- •Firm gland texture may be prognostic in patients taking perioperative pasireotide.
Abstract
Introduction
Postoperative pancreatic fistulas (POPFs) remain common; POPFs frequently require
intervention, termed clinically-relevant POPFs (crPOPFs). Pasireotide is increasingly
used to prevent POPF, however, risk factors for POPF in this population remain unexplored.
Methods
Patients undergoing pancreatectomy with perioperative pasireotide from 2013 to 2020
were identified from our institutional National Surgical Quality Improvement Project
database. Logistic regression was utilized to identify risk factors associated with
POPF.
Results
One-hundred patients were identified; 26 (26%) underwent distal pancreatectomy with
the remainder undergoing pancreaticoduodenectomy. Thirty (30%) experienced POPF, with
21 crPOPFs. Only current smoking was significantly associated with crPOPF (OR 3.79,
p = 0.04). Of 30 patients with a firm gland, none experienced crPOPF. Twenty-five
received a partial course of pasireotide; 7/25 (28%) crPOPFs occurred versus 14/75
(19%) in patients receiving a full course (p = 0.38).
Conclusion
Shortened courses of pasireotide do not increase crPOPF risk; selective discontinuation
may be suitable in low-risk patients. Smoking cessation should be encouraged.
Keywords
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Article info
Publication history
Published online: February 18, 2022
Accepted:
February 16,
2022
Received in revised form:
January 12,
2022
Received:
November 14,
2021
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
