BMJ 1994;309:604 (3 September)

Letters

Somatostatin in gastroenterology More studies needed

EDITOR, - We noted with concern the enthusiasm with which A Shulkes and J S Wilson endorse the use of somatostatin and its analogue octreotide in gastroenterology.1 In particular, we have reservations concerning the reported role of octreotide in the management of enterocutaneous fistula since, despite a successful pilot study,2 more studies seem warranted to clarify the timing and the cost-benefit of such treatment. Indeed, more recent studies of patients with such fistulas have failed to show any therapeutic advantage of octreotide.3

The work cited by Shulkes and Wilson was not, as they say, a controlled trial of octreotide but was a trial of a continuous intravenous infusion of native somatostatin.4 The impracticality and financial implications of such treatment, which was associated with only a six day improvement in the time taken to healing, seem difficult to justify. In addition, Shulkes and Wilson fail to take into account that the . . . [Full text of this article]


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Relevant Article

Somatostatin in gastroenterology
A Shulkes and J S Wilson
BMJ 1994 308: 1381-1382. [Extract] [Full Text]

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