Publisher's Synopsis
Upper gastrointestinal (UGI) bleeding, acute pancreatitis and postoperative complications after major pancreatic surgery have posed a persistent and often frustrating challenge to gastroenterologists, endoscopists and digestive surgeons for more than half a century. Although the effectiveness of somatostatin in the management of variceal bleeding, pancreatic fistula and prevention of postoperative complications is now clearly established, its use in UGI nonvariceal bleeding and acute pancreatitis is still debated and subjected to continuous investigation. In this supplement, a team of international experts presents an in-depth review of the current knowledge on the management of these difficult clinical conditions with this vasoactive peptide. After a review of the clinical pharmacology and safety of somatostatin and its analogs, an overview of the management strategies in UGI bleeding is presented. The place of somatostatin in the treatment of variceal and nonvariceal bleeding is then analyzed, attempting to better define the best drug and regimen. Finally the management of pancreatic fistula and prevention of postoperative complications with somatostatin or octreotide are thoroughly discussed An analysis of pharmacoeconomic issues, whose evaluation is becoming an essential part of any therapeutic guideline, completes this publication.
