{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T08:07:58Z","timestamp":1773648478654,"version":"3.50.1"},"reference-count":9,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T00:00:00Z","timestamp":1773619200000},"content-version":"vor","delay-in-days":15,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Enterocutaneous fistulas (ECFs) are serious postoperative complications associated with significant morbidity and mortality. Somatostatin analogues are widely used to reduce fistula output, although their effect on definitive closure remains uncertain. Evidence regarding long-acting formulations in postoperative ECFs is limited, particularly in the context of outpatient management. We report a case of delayed postoperative ECF following emergency distal gastrectomy for perforated gastric ulcer. The patient was managed non-operatively using sequential administration of short-acting Octreotide followed by long-acting Lanreotide. Conservative management avoided reoperation despite recurrent collections and prolonged fistula activity. Octreotide therapy was associated with reduction in fistula output, and transition to monthly Lanreotide enabled simplified outpatient care. The fistula subsequently closed without surgical re-intervention; however, spontaneous closure cannot be excluded as a contributing factor. This case emphasizes surgical decision-making in a hostile postoperative abdomen and the sequential use of somatostatin analogues in conservative community-based care.<\/jats:p>","DOI":"10.1093\/jscr\/rjag176","type":"journal-article","created":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T12:55:25Z","timestamp":1772283325000},"source":"Crossref","is-referenced-by-count":0,"title":["Conservative management of a delayed enterocutaneous fistula following emergency distal gastrectomy using sequential somatostatin analogues"],"prefix":"10.1093","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8071-0787","authenticated-orcid":false,"given":"Alexandra","family":"Zalums","sequence":"first","affiliation":[{"name":"The University of Sydney School of Rural Health - Orange Campus , 1530 Forest Road, Orange, NSW 2800 ,","place":["Australia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angus","family":"Hibberd","sequence":"additional","affiliation":[{"name":"Department of General Surgery , Orange Health Service, 1530 Forest Road, Orange, NSW 2800 ,","place":["Australia"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2026,3,16]]},"reference":[{"key":"2026031603292861000_ref1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s00268-012-1494-3","article-title":"Somatostatin analogues for the treatment of enterocutaneous fistulas: a systematic review and meta-analysis","volume":"36","author":"Coughlin","year":"2012","journal-title":"World J Surg"},{"key":"2026031603292861000_ref2","first-page":"228","article-title":"Are somatostatin analogues (octreotide and lanreotide) effective in promoting healing of enterocutaneous fistulas?","volume":"29","author":"Gray","year":"2002","journal-title":"J Wound Ostomy Continence Nurs"},{"key":"2026031603292861000_ref3","doi-asserted-by":"publisher","first-page":"727","DOI":"10.1111\/apt.18166","article-title":"Clinical trial: the effectiveness of long-acting somatostatin analogue for output reduction of high-output intestinal fistula or small bowel enterostomy. A randomised controlled trial","volume":"60","author":"Timmer","year":"2024","journal-title":"Aliment Pharmacol Ther"},{"key":"2026031603292861000_ref4","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1155\/2004\/901570","article-title":"Somatostatin versus octreotide in the treatment of patients with gastrointestinal and pancreatic fistulas","volume":"18","author":"Leandros","year":"2004","journal-title":"Can J Gastroenterol"},{"key":"2026031603292861000_ref5","doi-asserted-by":"publisher","first-page":"946","DOI":"10.1097\/SLA.0b013e318260aa26","article-title":"A meta-analysis of outcomes following use of somatostatin and its analogues for the management of enterocutaneous fistulas","volume":"256","author":"Rahbour","year":"2012","journal-title":"Ann Surg"},{"key":"2026031603292861000_ref6","doi-asserted-by":"publisher","first-page":"912","DOI":"10.1097\/MEG.0b013e32834a345d","article-title":"Systematic review and meta-analysis of the role of somatostatin and its analogues in the treatment of enterocutaneous fistula","volume":"23","author":"Stevens","year":"2011","journal-title":"Eur J Gastroenterol Hepatol"},{"key":"2026031603292861000_ref7","doi-asserted-by":"crossref","first-page":"872","DOI":"10.1097\/SLA.0b013e3181b2489f","article-title":"Randomized, placebo-controlled, double-blind study of the efficacy of lanreotide 30 mg PR in the treatment of pancreatic and enterocutaneous fistulae","volume":"250","author":"Gayral","year":"2009","journal-title":"Ann Surg"},{"key":"2026031603292861000_ref8","doi-asserted-by":"publisher","first-page":"1616","DOI":"10.1007\/s00268-007-9114-3","article-title":"A life-saving but inadequately discussed procedure: tube duodenostomy. Known and unknown aspects","volume":"31","author":"Isik","year":"2007","journal-title":"World J Surg"},{"key":"2026031603292861000_ref9","doi-asserted-by":"publisher","first-page":"1050","DOI":"10.1016\/j.amjsurg.2020.08.038","article-title":"Thirty-day outcomes in the operative management of intestinal-cutaneous fistulas: a NSQIP analysis","volume":"221","author":"Christensen","year":"2021","journal-title":"Am J Surg"}],"container-title":["Journal of Surgical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jscr\/article-pdf\/2026\/3\/rjag176\/67366842\/rjag176.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jscr\/article-pdf\/2026\/3\/rjag176\/67366842\/rjag176.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T07:29:33Z","timestamp":1773646173000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jscr\/article\/doi\/10.1093\/jscr\/rjag176\/8524609"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3]]},"references-count":9,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,3,6]]}},"URL":"https:\/\/doi.org\/10.1093\/jscr\/rjag176","relation":{},"ISSN":["2042-8812"],"issn-type":[{"value":"2042-8812","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,3]]},"published":{"date-parts":[[2026,3]]},"article-number":"rjag176"}}