gut microbiome patterns associated wieh somatostatin in patients undergoing pancreaticoduodenectomy:a prospective study

Postoperative pancreatic fistula (POPF) is a common and dreaded complication after pancreaticoduodenectomy (PD). The relationship between gut microbiome and POPF has yet to be established. This prospective study aims to analyze the influences of somatostatin on gut microbiome and to characterize the microbial alterations following POPF. 45 Patients were randomly divided into PD group and additional somatostatin therapy group. One fecal sample per patient was preoperatively collected to determine the baseline gut microbiome. Another fecal sample was obtained to observe longitudinal changes. After fecal collection, 50 samples of 25 patients were analyzed by 16S-rRNA gene sequencing. Somatostatin therapy was independent risk factor for affecting the occurrence of POPF and reduced diversity and richness of the gut microbiome. The abundance levels of certain bacteria in the gut microbiome have significantly changed after somatostatin therapy. This phenomenon was also found in patients with or without POPF. Based on the LEfSe analysis, Bifidobacterium and could be used as preoperative valuable biomarkers of somatostatin therapy. In addition, Ruminococcaceae and Akkermansia are microbial predictors to POPF. This prospective study identifies the influence of somatostatin on gut microbiome and discovers the significant biomarkers related to somatostatin and POPF. Our study suggests that gut microbiome may become a potential therapeutic target and diagnostic biomarker of POPF patients.