Success of prolonged therapy with the somatostatin analog, octreotide acetate, in recalcitrant enterocutaneous fistulas

The somatostatin analog, octreotide acetate, has been reported to accelerate closure of enterocutaneous fistulas (ECF), and, if the closure does occur, it does so within 10 days of therapy. We report on the closure in 2 consecutive patients with recalcitrant, high output ECF after 4 and 6 weeks of octreotide acetate therapy. The changes in fistula output volume and content in response to the drug are described. Since long-term treatment with this drug is generally well tolerated and easy to administer, at least a 6-week course should be considered before resorting lo surgical resection.