Octreotide bolus injection and azygos blood flow in patients with cirrhosis: is the effect really predictable?

Efficacy of octreotide for treatment of cirrhosis with refractory ascites: A meta-analysis

AIM: To evaluate the efficacy and safety of octreotide in the treatment of cirrhosis with refractory ascites.

METHODS: PubMed, EMBASE, CBM, CNKI, VIP and Wanfang Database were searched to retrieved studies evaluating the efficacy of octreotide in the treatment of cirrhosis with refractory ascites. All the related data that met our standards were extracted. The quality of the included trials was evaluated according to the Jadad score. RevMan 5.2 software was used for meta-analysis.

RESULTS: A total of 9 randomized controlled trials involving 696 patients were included. The results of meta-analysis showed that the octreotide group was superior to the control group in treatment efficiency (OR = 3.18, 95%CI: 2.03-4.97, P < 0.00001), weight reduction (MD = -8.75, 95%CI: -11.25--6.25, P < 0.00001), ascites reduction (SMD = -31.8, 95%CI: -35.23--28.37, P < 0.00001), decreased abdominal girth (SMD = -8.75, 95%CI: -11.55--5.95, P < 0.00001), increased blood urea nitrogen (BUN) (MD = -1.18, 95%CI: -2.31--0.06, P = 0.04) and 24 h urine volume (SMD = 8.18, 95%CI: 3.69-12.67, P = 0.0004), but there was no statistical difference in serum creatinine (sCr) or portal vein trunk diameter (PVD).

CONCLUSION: Current evidence suggests that octreotide could improve treatment efficiency in terms of weight reduction, ascites reduction, decreased abdominal girth, increased BUN and 24 h urine volume.

Prediction of octreotide efficacy by electrogastrography in the treatment of patients with esophageal variceal hemorrhage

Our aim is to investigate the significance of electrogastrography in the treatment of esophageal variceal hemorrhage with octreotide. Electrogastrography was performed in patients with esophageal variceal hemorrhage before and during the treatment consisting of various doses of octreotide (25 ug h(-1) group and 50 ug h(-1) group). The dominant power of electrogastrography and its relationship with the hemostatic efficacy of octreotide treatment were evaluated. Dominant power of electrogastrography decreased significantly during treatment with octreotide (P < 0.05). The reduction in the amplitude of dominant power in the 50 ug h(-1) group was significantly larger than in the 25 ug h(-1) group (P < 0.05), and it was correlated with hemostatic efficacy of octreotide treatment. We conclude that octreotide treatment in patients with esophageal variceal hemorrhage can result in a significant decrease of dominant power, which correlates with the hemostatic efficacy of octreotide, so the change of dominant power could be used as a predictor of evaluating the treatment efficacy of octreotide in esophageal variceal hemorrhage patients.