Somatostatin and its analogs in the management of postoperative pancreatic fistulas: A comprehensive review

doi:10.4240/wjgs.v18.i2.115417

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World Journal of Gastrointestinal Surgery

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1948-9366

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©Author(s) (or their employer(s)) 2026. No commercial re-use. See Permissions. Published by Baishideng Publishing Group Inc.

World J Gastrointest Surg. Feb 27, 2026; 18(2): 115417
Published online Feb 27, 2026. doi: 10.4240/wjgs.v18.i2.115417

Table 1 Comparative summary of somatostatin and its analogs in the prevention of postoperative pancreatic fistula

Agent	Mechanism	Evidence level	Effect on POPF	Limited factors
Somatostatin (IV infusion)	Pancreatic enzyme suppression (SSTR1-5)	High	Decrease POPF (strong, consistent)	Requires IV infusion
Pasireotide	Broad SSTR1-5 affinity	High (RCT + meta-analyses)	Decrease CR-POPF (56% RRR)	Cost, hyperglycemia
Octreotide	SSTR2, SSTR5 selective	Moderate	Decrease biochemical leaks; inconsistent CR-POPF	Dosing variability
Lanreotide	Long-acting SSTR2, SSTR5	Moderate	Modest POPF reduction	Limited data
Combined protocols (SSA + drainage)	Synergistic mechanical and pharmacologic control	Moderate-high	Decrease POPF and severity	Implementation complexity

SSA: Somatostatin analog; POPF: Postoperative pancreatic fistula; SSTR: Somatostatin receptor; RCT: Randomized controlled trial; CR-POPF: Clinically relevant postoperative pancreatic fistula; RRR: Relative risk reduction.

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Citation: Lazaridou L, Dimaki A, Vakalou K, Zervas V, Papadopoulos P, Koumarelas KE, Christodoulidis G. Somatostatin and its analogs in the management of postoperative pancreatic fistulas: A comprehensive review. World J Gastrointest Surg 2026; 18(2): 115417
URL: https://www.wjgnet.com/1948-9366/full/v18/i2/115417.htm
DOI: https://dx.doi.org/10.4240/wjgs.v18.i2.115417

Lazaridou L, Dimaki A, Vakalou K, Zervas V, Papadopoulos P, Koumarelas KE, Christodoulidis G. Somatostatin and its analogs in the management of postoperative pancreatic fistulas: A comprehensive review. World J Gastrointest Surg 2026; 18(2): 115417 [PMID: 41809322 DOI: 10.4240/wjgs.v18.i2.115417]

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