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Conservative Treatment of Postsurgical Lymphatic Leaks With Somatostatin-14^*

^* From the Departments of Surgery (Drs. Collard and Ponlot) and Intensive Care (Drs. Laterre and Reynaert), St-Luc Academic Hospital, Brussels, and Department of Internal Medicine (Dr. Boemer), Queen Astrid Hospital, Malmedy, Belgium.

Correspondence to: J.M. Collard, MD, Department of Surgery, St-Luc Academic Hospital, Hippocrate Avenue, 10, B–1200 Brussels, Belgium; e-mail: Collard{at}chir.ucl.ac.be

Successful management of lymphatic leaks by continuous IV administration of somatostatin was first reported by Ulibarri and coworkers in Spain,¹ and more recently by authors from Italy² and Switzerland.³ The present article reports the clinical history of two patients in whom postsurgical lymphatic leak was successfully treated after the administration of either somatostatin-14 alone (case 1) or combined somatostatin-14 and total parenteral nutrition (TPN; case 2). Although further pathophysiologic studies are needed for the elucidation of its mechanisms of action, somatostatin-14 seems to be an intriguing therapy against postsurgical lymphatic leaks that may make potentially risky transthoracic reoperation unnecessary.

Key Words: fistula • somatostatin • thoracic duct

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