Adjunctive Octreotide for Moderate-to-Severe Acute Pancreatitis: A Prospective Comparative Study in Iraqi Patients

Background: Acute pancreatitis (AP) remains a major cause of gastrointestinal hospitalization and can progress to systemic inflammatory response, organ failure, and death. Management is primarily supportive. Octreotide has been proposed to reduce pancreatic exocrine secretion and inflammatory progression, but clinical effectiveness is still controversial, with some studies suggesting it may help reduce complications and improve outcomes in patients with acute pancreatitis. Objective: To investigate the effect of octreotide in the treatment of moderate-to-severe acute pancreatitis in Iraqi patients. Methods: A prospective, pragmatic comparative study was conducted at Baghdad Teaching Hospital, Medical City, Iraq (November 2021–November 2023). Seventy-eight patients with moderate-to-severe AP were included and allocated into a control group receiving conservative management (n=40) and an octreotide group receiving conservative management plus octreotide (0.1 mg subcutaneously every 6 hours for 7 days) (n=38). Outcomes included in-hospital complications, discharge status, mortality, and length of hospital stay. Results: Baseline characteristics were comparable between groups (p>0.05). Complication rates were numerically lower in the octreotide group, including ARDS (7.89% vs. 17.5%), septicemia (18.42% vs. 32.5%), renal failure (5.26% vs. 10.0%), abscess (2.63% vs. 7.5%), and pseudocyst (7.89% vs. 15.0%), though differences were not statistically significant (p>0.05). Mortality was lower with octreotide (10.5% vs. 17.5%). Cure and discharge occurred in 81.57% of octreotide-treated patients versus 65.0% in controls. The mean hospital stay was 12.95±5.74 vs. 11.05±5.31 days, respectively (p=0.133). Conclusions: Octreotide showed favorable clinical trends in reducing complications and improving discharge outcomes, but larger randomized trials are needed to confirm efficacy.