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.