OBJECTIVE: The purpose of this nonrandomized retrospective study was to report our new procedures using polyethylene glycolic acid (PGA) felt with fibrin sealant to prevent severe pancreatic fistula in patients undergoing pancreatic surgery. METHODS: From 2000 to 2008, 54 and 63 patients underwent pancreaticoduodenectomy (PD) and distal pancreatectomy (DP), respectively. Of those patients, we applied PGA felt with fibrin sealant to 18 PD patients and 26 DP patients. In PD patients, the PGA felt was wrapped around the pancreatic suture site, while in DP patients, the PGA felt was wrapped around the predictive division site. The pancreaticojejunostomy site in PD patients and the cut stump in DP patients were coated with fibrin sealant. We compared the occurrence rates for severe postoperative pancreatic fistula (POPF) that occurred after PD or DP both with and without our new procedures. RESULTS: Before introduction of our procedures, severe POPF developed in 14 of 36 PD patients (39%) and 10 of 37 DP patients (27%). In contrast, after introduction of our procedures, the incidence of POPF was only one in both of 18 PD (6%; P = 0.016) and 26 DP (4%; P = 0.017) patients. CONCLUSION: In summary, our procedure using PGA felt with fibrin sealant may reduce the risk of severe POPF.
OBJECTIVE: The purpose of this nonrandomized retrospective study was to report our new procedures using polyethylene glycolic acid (PGA) felt with fibrin sealant to prevent severe pancreatic fistula in patients undergoing pancreatic surgery. METHODS: From 2000 to 2008, 54 and 63 patients underwent pancreaticoduodenectomy (PD) and distal pancreatectomy (DP), respectively. Of those patients, we applied PGA felt with fibrin sealant to 18 PDpatients and 26 DPpatients. In PDpatients, the PGA felt was wrapped around the pancreatic suture site, while in DPpatients, the PGA felt was wrapped around the predictive division site. The pancreaticojejunostomy site in PDpatients and the cut stump in DPpatients were coated with fibrin sealant. We compared the occurrence rates for severe postoperative pancreatic fistula (POPF) that occurred after PD or DP both with and without our new procedures. RESULTS: Before introduction of our procedures, severe POPF developed in 14 of 36 PDpatients (39%) and 10 of 37 DPpatients (27%). In contrast, after introduction of our procedures, the incidence of POPF was only one in both of 18 PD (6%; P = 0.016) and 26 DP (4%; P = 0.017) patients. CONCLUSION: In summary, our procedure using PGA felt with fibrin sealant may reduce the risk of severe POPF.
Authors: J Rubén Rodríguez; Santos Soto Germes; Pari V Pandharipande; G Scott Gazelle; Sarah P Thayer; Andrew L Warshaw; Carlos Fernández-del Castillo Journal: Arch Surg Date: 2006-04
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