Editorial Commentary on “Somatostatin Infusions Reduce Post-Operative Cholorrhoea after Hepatopancreatobiliary Surgery: An Observational Preliminary Study”

In this issue of the British Journal of Medicine and Medical Research, Pitiakoudis and colleagues publish their paper entitled " Somatostatin infusions reduce post-operative cholorrhoea after hepatopancreatobiliary surgery. An observational preliminary study " [1]. Somatostain has numerous physiological properties, including its inhibitor effect on bile secretion. This property has been used by Pitiakoudis and colleagues to treat patients with bile leak after hepatopancreatobiliary (HPB) surgery. This interesting but preliminary study has showed promising results. However the data presented in this study cannot be used to definitely support the routine use of somatostatin in patients with bile leak after HPB surgery, because significant limitations and potential biases can be found in this study. This study consists of a very heterogeneous group of patients; furthermoew the number of patients included is very small (n=15). The patients were highly selected and there is little data to show whether adding somatostatin to traditional conservative treatment, has truly been able to speed up healing of biliary fistulae. In fact is not clear whether the authors have used Somatostatin as an adjunct to conservative management, combined to Percutaneous drainage and eventual ERCP (Endoscopic retrograde cholangiopancreatography) +/-biliary stent or if Somatostin was the only treatment besides TPN, therefore allowing avoidance of Percutaneous drainage and/or ERCP +/-biliary stent.