DOI: http://dx.doi.org/10.18203/2349-2902.isj20221140

Comparative study between omega 3 fatty acid infusion versus octreotide in management of acute pancreatitis

Sugandh Arockia, Sivarajan Natraj

Abstract


Background: Acute pancreatitis is one of the commonest diseases. While some use octreotide infusion, some rely only on fluid therapy and symptomatic treatment. Ongoing research has commented about omega (ω) 3 fatty acid (FA) infusions being the future of acute pancreatitis treatment as it is cheap and has lesser side effects.

Methods: This prospective comparative study was done in patients with acute pancreatitis. Patients were divided into two groups, with group A receiving ω-3 FA single-dose infusion of 60 ml/hour over 4-5 hours and the other group B were subjected to injection of octreotide 100 mcg IV 8th hourly for 5 days with IV fluids. The groups were compared based on improvement in biochemical markers, BISAP score and hospital stay.

Results: 132 patients were divided into 2 groups, on day 3 serum amylase levels in the ω-3 FA group were 268.54±65.84, and the octreotide group was 299.18±94.31 (p value=0.032). Day 3 serum lipase levels in the ω-3 FA group were 137.07±62.19, and the octreotide group was 172.07±72.46 (p value=0.002). Day 3 BISAP score in the ω-3 FA group was 1.21±0.41, and the octreotide group was 1.39±0.49 (p value=0.023). The duration of hospital stay in the ω-3 FA group was 8.03±1.09 days and in the octreotide group was 11.83±1.04 days (p<0.0001).

Conclusions: Patients receiving ω-3 FA reported lower amylase-lipase levels along with a lower BISAP score. Hence looking for a cheaper and safer alternative, ω-3 FA infusion could reduce the problem on the patient and hospitalization concomitant expenses.


Keywords


Pancreatitis, Octreotide, Omega 3 FA

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References


Gapp J, Chandra S. Acute Pancreatitis. Treasure Island (FL): StatPearls Publishing. Available at: https://www.ncbi.nlm.nih.gov/books/NBK482468/. Accessed on 26 June 2021.

Testoni PA. Acute recurrent pancreatitis: Etiopathogenesis, diagnosis and treatment. World J Gastroenterol. 2014;20:16891.

Glasbrenner B, Adler G. Pathophysiology of acute pancreatitis. Hepatogastroenterology. 1993;40(6):517-21.

Zerem E. Treatment of severe acute pancreatitis and its complications. World J Gastroenterol. 2014;20:13879-92.

Lei QC, Wang XY, Xia XF, Zheng HZ, Bi JC, Tian F, et al. The role of omega-3 fatty acids in acute pancreatitis: a meta-analysis of randomized controlled trials. Nutrients. 2015;7:2261-73.

Rudraiah HGM, Kalke SV, Desai A. A novel treatment protocol in acute pancreatitis: the first double blinded comparative trial of omega 3 fatty acid infusion versus octreotide. Int Surg J. 2018;5:4052.

van Santvoort HC, Besselink MG, Bakker OJ, Hofker HS, Boermeester MA, Dejong CH, et al. A step-up approach or open necrosectomy for necrotizing pancreatitis. N Engl J Med. 2010;362:1491-502.

Narayanswamy SS. A double blinded comparative study between omega 3 fatty acid infusion versus octreotide infusion in acute pancreatitis. Int Surg J. 2020;7:3251.

Choudari CP, Fogel EL, Sherman S, Lehman GA. Idiopathic pancreatitis: yield of ERCP correlated with patient age. Am J Gastroenterol. 1998;93:1654.

Kimura Y, Arata S, Takada T, Hirata K, Yoshida M, Mayumi T, et al. J Hepato-biliary-pancreatic Sci. 2010;17:60-9.

Cui J, Xiong J, Zhang Y, Peng T, Huang M, Lin Y, et al. Serum lactate dehydrogenase is predictive of persistent organ failure in acute pancreatitis. J Crit Care. 2017;41:161-5.

Matull WR, Pereira SP, O’Donohue JW. Biochemical markers of acute pancreatitis. J Clin Pathol. 2006;59:340-4.

Pokharel A, Sigdel PR, Phuyal S, Kansakar PBS, Vaidya P. Prediction of severity of acute pancreatitis using total serum calcium and albumin-corrected calcium: A prospective study in tertiary center hospital in Nepal. Surg Res Pract. 2017;1-5.

Kilian M, Heukamp I, Gregor JI, Schimke I, Kristiansen G, Wenger FA. Fish oil, but not soy bean or olive oil enriched infusion decreases histopathological severity of acute pancreatitis in rats without affecting eicosanoid synthesis. Inflammation. 2011;34:597-602.