Abstract
Octreotide was used to treat eight patients with acromegaly. Octreotide dose was increased to 1500 mcg subcutaneously per day during the first year, and was then reduced to 600 mcg per day for three years.
After three years of therapy five patients had asymptomatic gallstones. A study of bile salt dissolution therapy (chenodeoxycholic and ursodeoxycholic acid, 7.5 mg/kg of each drug daily in divided doses) was performed with these patients for one year while octreotide treatment was continued. After six months of therapy repeat ultrasound examination showed disappearance of gallstones in one case, and after one year gallstones had disappeared in another two patients. Medical gallstone dissolution is possible during continuous octreotide treatment.
Similar content being viewed by others
References
Ross, D. A., Wilson, C. B. Results of transsphenoidal microsurgery for growth hormone-secreting pituitary adenoma in a series of 214 patients. J. Neurosurg. 1988; 68: 854–67.
Frohman, L. A. Clinical review 22: Therapeutic options in acromegaly. J. Clin. Endocrinol. Metab. 1991;72: 1175–81.
McKnight, J. A., McCance, D.R., Crothers, J. G., Atkinson, A. B. Changes in glucose tolerance and development of gall stones during high dose treatment with octreotide for acromegaly. Br. Med. J. 1989; 299: 604–05.
Eastman, R. C., Arakaki, R. F., Shawker, T. et al. A prospective examination of octreotide-induced gall-bladder changes in acromegaly. Clin. Endocrinol. 1992; 36: 265–9.
Bigg-Wither, G. W., Ho, K. K. Y., Grunstein, R. R., Sullivan, C. E., Doust, B. D. Effects of long term octreotide in gall stone formation and gall bladder function. Br. Med. J. 1992; 304: 1611–2.
Plockinger, U., Dienemann, D., Quabbe H-J. Gastrointestinal side-effects of octreotide during long term treatment of acromegaly. J. Clin. Endocrinol. Metab. 1990; 71: 1658–62.
Ho, K. Y., Weissberger, A. J., Marbach, P., Lazarus, L. Therapeutic efficacy of the somatostatin analog SMS 201–995 (octreotide) in acromegaly. Ann. Intern. Med. 1990; 112: 173–81.
Page, M. D., Millward, M. E., Taylor, A. et al. Long-term treatment of acromegaly with a long-acting analogue of somatostatin, octreotide. Q. J. Med. 1990; 74: 189–201.
James, R. A., Rhodes, M., Rose, P., Kendall-Taylor, P. Biliary colic on abrupt withdrawal of octreotide. Lancet 1991; 338: 1527.
Sadoul, J-L., Benchimol, D., Thyss, A., Freychet, P. Acute pancreatitis following octreotide withdrawal. Am. J. Med. 1991; 90:763–4.
Van Liessum, P. A., Hopman, W. P. M., Pieters, G. F. F. M. et al. Post-prandial gall bladder motility during long term treatment with the long-acting somatostatin analog SMS 201–995 in acromegaly. J. Clin. Endocrinol. Metab. 1989; 69:557–62.
Rhodes, M., James, R. A., Bird, M., Clayton, B., Kendall-Taylor, P., Lennard, T. W. J. Gall bladder function in acromegalic patients taking long-term octreotide: evidence of rebound hypermotility on cessation of treatment. Scand. J. Gastroenterol. 1992; 27: 115–8.
Fisher, R. S., Rock, E., Levin, G., Malmud, L. Effects of somatostatin on gallbladder emptying. Gastroenterol. 1987; 92: 885–90.
Magnusson, I., Einarsson, K., Angelin, B., Nyberg, B., Bergstrom, K., Thulin, L. Effects of somatostatin on hepatic bile formation. Gastroenterol. 1989; 96: 206–12.
Buscail, L., Tauber, J. P., Escourrou, J. et al. Gallstone formation and occurrence of cholesterol monohydrate crystals in gallbladder bile of patients with long-term sandostatin treatment. Gastroenterol. 1989; 96 (5 part 2): A580.
Ahrendt, S. A., McGuire, G. E., Pitt, H. A., Lillemoe, K. D. Why does somatostatin cause gallstones? Am. J. Surg. 1991; 161: 171–83.
Arakaki, R., Shawker, T., Schock, R., Coe, L., Comi, R., Gorden, P. Gall bladder abnormalities in acromegalics treated with octreotide. Clin. Res. 1990; 38: 525A.
Schmidt, K., Leuschner, M., Harris, A. G., Althoff, P. H., Jacobi, V., Jungmann, E., Schumm-Draeger, P. M., Rau, H., Braulke, C., Usadel, K. H. Gallstones in acromegalic patients undergoing different treatment regimens. Clin Invesig. 1992; 70(7): 556–9.
Hickman, M. S., Schwesinger, W. H., Bova, J. D., Kurtin, W. E. Computed tomographic analysis of gallstones: An in vitro study. Arch. Surg. 1986; 121: 289–91.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
McKnight, J.A., McCance, D.R., Crothers, J.G. et al. Incidence and medical treatment of octreotide induced gallstones in subjects with resistant acromegaly: A prospective study. I.J.M.S. 163, 25–27 (1994). https://doi.org/10.1007/BF02943009
Issue Date:
DOI: https://doi.org/10.1007/BF02943009