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2000, Número 3

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Cir Gen 2000; 22 (3)


Efectividad terapéutica del octreotide (análogo de la somatostatina) en pacientes con problemas quirúrgicos gastrointestinales

Juárez CD, Butrón LFG, Sentíes CS, Flores GS, Nangullasmu AA, Hernández CJF

Idioma: Español
Referencias bibliográficas: 57
Paginas: 221-225
Archivo PDF: 65.11 Kb.


RESUMEN

Objetivo: Comprobar la efectividad terapéutica del octreotide en algunas complicaciones quirúrgicas gastrointestinales.
Sede: Hospitales de segundo nivel de atención.
Diseño: Estudio clínico, prospectivo, longitudinal, sin grupo control.
Pacientes y métodos: Se incluyeron 29 pacientes consecutivos con los siguientes diagnósticos: Dieciocho con fístula gastrointestinal, cuatro con pancreatitis aguda, tres con síndrome de “dumping” dos con oclusión intestinal por adherencias, dos con ileostomía de gasto alto y uno con diarrea post-vagotomía. Todos fueron tratados con octreotide a dosis que variaron entre 100 y 200 µg por vía subcutánea. Se evaluaron las siguientes variables: Cierre espontáneo de la fístula, disminución del gasto y tiempo de resolución. Se empleó nutrición parenteral total en los pacientes que lo requirieron.
Resultados: El cierre espontáneo de la fístula fue del 100%, en siete días en las entéricas, en nueve en las biliares y pancreáticas, y en 14 en las gástricas y duodenales. En los pacientes con síndrome de “dumping” los síntomas gastrointestinales y vasomotores se redujeron aunque no desaparecieron; en el paciente con diarrea post-vagotomía ésta se controló a largo plazo, 4 a 6 meses. No hubo respuesta terapéutica en los pacientes con oclusión intestinal, ileostomía y pancreatitis.
Conclusión: El octreotide resultó efectivo en el tratamiento de las fístulas del tracto digestivo.


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