Effect of Somatostatin on hepatic blood flow: preliminary results

Abstract

Background: Somatostatin (SOMATO) administration affects hepatic blood flow (HBF); however, its clinical effect remains ill-defined. The aim of this study is to assess the clinical effects of SOMATO administration on HBF during major abdominal surgery by comparing HBF in patients with and without intra-operative SOMATO admin-istration. Methods: This retrospective analysis used data from two separate prospective studies including patients undergoing pancreaticoduodenectomy and was approved by the Ghent University Hospital ethical committee. All patients received total intravenous an-esthesia, using target-controlled infusion, and guided by a depth of anesthesia monitor. Schnider model was used for propofol, and Minto model was used for remifentanil. All patients received goal-directed hemodynamic therapy guided and recorded by Pul-sioFlex monitoring (Getinge Group). Portal vein blood flow and arterial hepatic blood flow were measured using ultrasound transit time flow measurements (Medi-Stim®). Both PVF and HAF were indexed using cardiac index. Patients were divided in two groups, receiving SOMATO (group S) versus control group not receiving SOMATO (group C). The Shapiro-Wilk test was used for testing normal distribution. Statistical testing was done using a Welch T-test or a Wilcoxon test. Results: From 6/2017 to 10/2020, a total of thirty-seven patients were analyzed. Twenty-five patients received SOMATO (group S) whereas twelve patients did not (group C). In Group S, PVFi was significantly reduced in patients receiving SOMATO compared to the control group (p = 0.005). HAFi was similar in both groups. The net effect on total HBFi was significantly lower in group S (p = 0.027). Hemodynamic parameters did not differ between both groups. Conclusions: SOMATO significantly reduced PVFi in the surgical patients while HAFi remained similar in both groups. As a result, total HBFi was significantly lower in SO-MATO-treated patients.