Somatostatin analogues are used to prevent postoperative pancreatic fistulas. In our practice, in case of high output duodenal fistula, we use somatostatin analogues together with proton pump inhibitors, bowel rest and parenteral nutrition.

Of course this is an appropriate indication. Depending of the origin, length and amount of drainage daily it must be supplemented with IBPs and enteral nutrition using a jejunal tube

We use Somatostatin analogues  to prevent postoperative pancreatic fistulas in Pancreticduodenectomy. In our practice, in case of high output fistula, we use somatostatin analogues too but with special atention to sepsis in order to indicate re-operation.

Can Somatostatin analogue help to Control Benign Duodenal 3rd part Fistula Output? - ResearchGate. Available from: https://www.researchgate.net/post/Can_Somatostatin_analogue_help_to_Control_Benign_Duodenal_3rd_part_Fistula_Output [accessed Jul 13, 2016].

definitely will help but no guarantee that it will lead to complete cure but at least it worth trial in low output fistula with no sepsis or contained collection

Dear Dr malik

as you know ,management of fistula depends to many factors such as the cause,out put, obstruction ,foreign body and ...

normally we use octrotide as a GI switch off to reduce the fistula out put but interestingly when you start the feeding to patients the rate of fistula will decrease.

Dear Mr Malik,

Somatostatin Analogue along with PPI may help in decreasing the fistula output. But other factors are also important. Control of sepsis and Nutrition through a Jejunostomy tube feeding is really important. Early enteral (jejunostomy)( after bypassing the D3) feeding would help.

It would be useful, but you need to maintain a continuos perfusion during 5-7 days and also to use complementary useful therapeutics

I am very thankful for your feedback .Atraumatic D3 perforation is quite unusual.I believe Somatostatin Analogue will heal the D3 perforation in a better way if we address other factors too.