Somatostatin analogue SMS 201–995 (octreotide) as a possible solution to the dumping syndrome after gastrectomy or vagotomy

The dumping syndrome, which may follow partial gastrectomy or truncal vagotomy and drainage, may be refractory to treatment. The aim of this study was to determine the effect of the somatostatin analogue. SMS 201‐995 (octreotide), on dumping provoked by hypertonic glucose. Ten patients with symptoms and signs of dumping were studied. After a dumping provocation test with placebo, all patients developed severe symptoms: seven patients had early dumping, two had both early and late dumping and one had late dumping alone. With either 50 or 100 μg SMS 201‐995, the symptoms of early dumping were much reduced in all patients, and those of late dumping were completely abolished. The packed cell volume, pulse and systolic blood pressure changes of early dumping were significantly reduced by SMS 201‐995 and the fall in blood glucose in patients with late dumping was abolished. SMS 201‐995 may be a useful treatment for early and late dumping.

[1]  A. Cuschieri.  Surgical management of severe intractable postvagotomy diarrhoea , 1986, The British journal of surgery.

[2]  J. Burrin,et al.  EFFECTIVE AND LASTING GROWTH-HORMONE SUPPRESSION IN ACTIVE ACROMEGALY WITH ORAL ADMINISTRATION OF SOMATOSTATIN ANALOGUE SMS 201-995 , 1986, The Lancet.

[3]  N. Parr.  Cimetidine and gastrointestinal haemorrhage in critically ill patients. , 1986, Gut.

[4]  T. Adrian,et al.  Somatostatin and the dumping syndrome. , 1985, British medical journal.

[5]  C. Stoddard,et al.  The four to eight year results of the Sheffield trial of elective duodenal ulcer surgery—highly selective or truncal vagotomy? , 1984, The British journal of surgery.

[6]  N. Matheson,et al.  A comparison of highly selective vagotomy with truncal vagotomy and pyloroplasty—one surgeon's results after 5 years , 1983, The British journal of surgery.

[7]  S. Bloom,et al.  Release of vasoactive intestinal peptide in the dumping syndrome. , 1981, British medical journal.

[8]  S. Bloom,et al.  Elevation of plasma neurotensin in the dumping syndrome. , 1980, Clinical science.

[9]  M. Hobsley,et al.  The relationship between the rate of gastric emptying and the dumping syndrome , 1978, The British journal of surgery.

[10]  D. Johnston,et al.  Effects of truncal, selective, and highly selective vagotomy on glucose tolerance and insulin secretion in patients with duodenal ulcer. Part I-Effect of vagotomy on response to oral glucose. , 1975, British medical journal.

[11]  S. Bloom,et al.  Enteroglucagon release in the dumping syndrome. , 1972, Lancet.

[12]  F. T. de Dombal,et al.  Five to eight-year results of Leeds-York controlled trial of elective surgery for duodenal ulcer. , 1968, British medical journal.