Effect of Octreotide (Sandostatin 201-995) on Bile Flow and Bile Components MUSTAFA SAHIN, MD, ADIL KARTAL, MD, METIN BELVIRANLI, MD, SERDAR YOL, MD, FARUK AKSOY, MD, and MEHMET AK, MD Octreotide (Sandostatin 201-995) has an inhibitory effect on gastric, intestinal, and pancreatic secretions and hepatic and splachnic blood ¯ow. We examined the effects of octreotide on bile ¯ow and bile components in 10 patients with T-tube choledochostomy. A Fogarty balloon catheter was inserted distal to the T-tube of these patients for measurement of bile ¯ow and bile components. Bile samples were obtained to analyze bile acid, phospholipid, lipoprotein, and cholesterol, and bile ¯ow measurements were performed every 15 min for a period of 90 min before study and after normal saline and octreotide administrations. While octreotide had an inhibitory effect on bile ¯ow, the concentrations of bile acid, phospholipid, and lipoprote in in bile were increased with octreotide. KEY WORDS: octreotide; somatostatin; bile ¯ow; bile components. Somatostatin is a natural tetradecapeptide and has a short half-life of 2±3 min. It has side effects and it is unstable in solution. Because of these features, its use in medicine is limited (1±3). A long-acting, synthetic octapeptide analog of somatostatin, octreotide (SMS 201-995) , has been develope d. It has a longe r half-life , fewer side effects, and it is more effective than soma- tostatin (4 ±7). Octreotide is proved to decrease gas- tric, intestinal, and pancreatic secretions as well as hepatic and splachnic blood ¯ows (4, 8, 9). Previous studies have shown that somatostatin decreases bile ¯ow, but the effect of somatostatin on bile compo- nents has rarely been studied (1, 2). We designed a prospective study to assess the effect of octreotide on bile ¯ow and bile components. MATERIALS AND METHODS This study was performed at the University of Selcuk, School of Medicine, Department of Surgery between Jan- uary and October 1993. There were 10 patients (all females) with a median age of 48 (range: 40±65). Case material included the patients with diagnosis of cholelithiasis and choledocholithiasis who underwent open cholecystectomy and T-tube choledochostomy. A Fogarty catheter was in- serted through a pinhole opening into the common bile duct distal to the T-tube for the purpose of complete diversion of bile ¯ow during bile sampling and bile ¯ow measurements. On postoperative day 11, blood samples were drawn for liver function tests and T-tube cholangiograms were per- formed to rule out retained stones and evaluate bile ¯ow into the duodenum. After receiving the results of normal liver function tests and achieving satisfactory cholangio- grams, patients fasted overnight. Subsequently, all patients were administered intravenous isotonic saline solution 6 cc/min for 60 min. Bile samples were collected and bile ¯ow measurements were performed at every 15 min starting with infusion of isotonic saline solution for a period of 90 min (control group). On postoperative day 12, following overnight fasting, all patients received intravenous octreotide (Sandostatin, San- doz Pharmaceuticals, Basel, Switzerland) 100 mg/hr in 350 ml of isotonic saline solution (octreotide group). Bile sam- ples were collected and bile ¯ow measurements were per- formed as described above. All bile samplings and measurements of bile ¯ow were performed with complete diversion of bile ¯ow to T-tube via blockage of bile ¯ow to the duodenum with an in¯ated Manuscript received October 18, 1995; accepted January 31, 1997. From the Department of Surgery, University of Selcuk, School of Medicine, Konya, Turkey. Address for reprint requests: Dr. Mustafa Sahin, Department of Surgery, Inonu University School of Medicine, Malatya, Turkey. Digestive Diseases and Sciences, Vol. 44, No. 1 (January 1999), pp. 181±185 181 Digestive Diseases and Sciences, Vol. 44, No. 1 (January 1999) 0163-2116/99/0100-0181$16.00/0 Ñ 1999 Plenum Publishing Corporation