Evidence for using somatostatin analogues in the treatment of enterocutaneous fistula

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Abstract

Enterocutaneous fistulas cause considerable mortality and morbidity following gastrointestinal surgery. Most occur after surgery for malignant, diverticular or inflammatory bowel disease; fewer patients with these conditions develop fistulas spontaneously. Care is often long and costly 1 , although spontaneous closure can occur with non-operative management in 60-75 per of patients 2 . The goals of management for enterocutaneous fistula are therefore to promote conditions for spontaneous fistula closure or, if this is not possible, to restore physiological stability in order to optimize the patient for definitive surgery. Although somatostatin analogues are used widely as part of this management plan, the evidence for their use is questionable.

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