Cholelithiasis during Octreotide Therapy

PICO Question

In patients undergoing long term therapy with octreotide what is the incidence of cholelithiasis compared to untreated patients and what is the outcome of patients with cholelithiasis?

Gallstones occur very commonly in patients on long term octreotide therapy  (Sandostatin) and infrequently require cholecystectomy.

Selected Studies

Hussaini, S. H., Pereira, S. P., Veysey, M. J., Kennedy, C., Jenkins, P., Murphy, G. M., et al. (1996). Roles of gall bladder emptying and intestinal transit in the pathogenesis of octreotide induced gall bladder stones. Gut, 38(5), 775–783.

  • Study population: acromegalic patients vs controls examining effect of octreotide
  • A single dose of Octreotide 50 mug essentially abolished meal stimulated (Ensure 250 ml) gall bladder emptying in both acromegalic and control subjects
  • Octreotide prolongs small bowel transit time
  • Nice graphs

 

Trendle, M. C., Moertel, C. G., & Kvols, L. K. (1997). Incidence and morbidity of cholelithiasis in patients receiving chronic octreotide for metastatic carcinoid and malignant islet cell tumors. Cancer, 79(4), 830–834.

  • Study population: patients with metastatic carcinoid or malignant pancreatic islet cell tumors who were receiving chronic therapy with octreotide.
  • Among 44 patients followed over about 50 months, approximately 50% developed cholelithiasis.  The incidence of acute cholecystitis was about 11%.

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Created and maintained by Raf Rizk, MD | Division of Gastroenterology | Michigan Medicine

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