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John L. Gray, MD; Haile T. Debas, MD; Sean J. Mulvihill, MD

Arch Surg. 1991;126(10):1231-1236.

Abstract
• Octreotide acetate is a long-acting analogue of the naturally occurring inhibitory gastrointestinal peptide, somatostatin. We tested the efficacy of octreotide in controlling the symptoms of dumping syndrome in response to a provocative meal in a randomized, double-blinded, crossover trial in nine severely affected patients. Pretreatment with octreotide acetate (100 µg injected subcutaneously) reduced postprandial dumping symptoms from a mean±SEM score of 15.7±1.6 (placebo treatment day) to 4.6±1.7. With placebo treatment, all nine patients became symptomatic in response to the meal, whereas with octreotide treatment, symptoms occurred in only two of nine patients. Similarly, all placebo-treated patients showed a postprandial increase in pulse rate to a mean±SEM of 105±6 beats per minute, whereas only one of nine octreotide-treated patients showed an increase in pulse rate (mean±SEM, 80±3 beats per minute). These differences were also statistically significant. While no significant changes were observed in postprandial hematocrit values or osmolality between placebo and octreotide treatments, octreotide prevented hypoglycemia in four affected patients and significantly inhibited insulin release. We conclude that octreotide is a useful tool in the treatment of patients with severe, refractory dumping syndrome.

(Arch Surg. 1991;126:1231-1236)

Author Affiliations
From the Department of Surgery, University of California, San Francisco.

Footnotes
Accepted for publication June 15, 1991.

Presented at the 62nd Annual Scientific Session of the Pacific Coast Surgical Association, Pebble Beach, Calif, February 19, 1991.

Reprint requests to Department of Surgery, University of California, San Francisco Medical Center, San Francisco, CA 94143-0788 (Dr Mulvihill).

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