Octreotide in the treatment of thoracic duct injuries.

摘要: Anecdotal reports support the use of octreotide in treatment traumatic thoracic duct injuries and chylothorax, but no prospective studies have proved its efficacy. We evaluated effects treating transection a canine model. Eight mongrel dogs (27.8 + 5.1 kg) were fed one pint 10.5 per cent milkfat 2 hours before operation. Through left supraclavicular neck incision, was identified transected, producing free flow chyle. A quarter-inch drain tunneled subcutaneously from wound attached to closed suction. After closure randomized control group (n = 4) receiving sham injections saline three times day, or given 3 μg/kg day. Postoperatively all standard low-fat (5-7%) crude fat diet. Drain output measured each on odd-numbered postoperative days drainage analyzed for cholesterol, triglycerides, albumin, total protein. Fistula defined as <10 ml/24-hour period. Treated achieved fistula significantly faster than controls: 3.5 ± 1.3 versus 7.8 1.0 (P 0.0037). Whereas equivalent amounts occurred day surgery both groups, by had less over 24 hours: 63 69 ml 195 79 0.046); this significant difference persisted through 5 when began decrease group. No differences between groups seen levels protein at any time point. conclude that is effective injury, leading an early closure. The mechanism effect remains be clarified.