Norifumi Tsutsumi1, Morimasa Tomikawa2, Tomohiko Akahoshi3, Hirofumi Kawanaka4, Mitsuhiko Ota5, Yoshihisa Sakaguchi5, Tetsuya Kusumoto5, Koji Ikejiri5, Makoto Hashizume2, Yoshihiko Maehara3. 1. Department of Surgery, Center for Gastroenterology, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-ku, Fukuoka 810-8563, Japan. Electronic address: tnori@surg2.med.kyushu-u.ac.jp. 2. Department of Advanced Medicine and Innovative Technology, Kyushu University Hospital, Fukuoka, Japan. 3. Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. 4. Clinical Research Institute, National Hospital Organization, Beppu Medical Center, Beppu, Japan. 5. Department of Surgery, Center for Gastroenterology, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-ku, Fukuoka 810-8563, Japan.
Abstract
BACKGROUND: This study aimed to determine the effect of fibrin glue and polyglycolic acid (PGA) felt on prevention of pancreatic fistula (PF) after laparoscopic splenectomy in patients with hypersplenism due to liver cirrhosis. METHODS: Fifty consecutive patients were enrolled in this prospective study. Twenty-three patients underwent laparoscopic splenectomy with a fibrin sheet (fibrin sheet group). The sealing ability of each treatment was evaluated by an ex vivo pressure test model. Based on the results from ex vivo experiments, 27 patients received prophylaxis using fibrin glue and PGA felt (PGA with fibrin group). The primary endpoint was the incidence of PF. RESULTS: Significantly more (5, 22%) patients developed PF in the fibrin sheet group than in the PGA with fibrin group (0%, P = .037). CONCLUSIONS: Our new application of fibrin glue and PGA felt is an effective prophylactic procedure for preventing development of PF after laparoscopic splenectomy.
BACKGROUND: This study aimed to determine the effect of fibrin glue and polyglycolic acid (PGA) felt on prevention of pancreatic fistula (PF) after laparoscopic splenectomy in patients with hypersplenism due to liver cirrhosis. METHODS: Fifty consecutive patients were enrolled in this prospective study. Twenty-three patients underwent laparoscopic splenectomy with a fibrin sheet (fibrin sheet group). The sealing ability of each treatment was evaluated by an ex vivo pressure test model. Based on the results from ex vivo experiments, 27 patients received prophylaxis using fibrin glue and PGA felt (PGA with fibrin group). The primary endpoint was the incidence of PF. RESULTS: Significantly more (5, 22%) patients developed PF in the fibrin sheet group than in the PGA with fibrin group (0%, P = .037). CONCLUSIONS: Our new application of fibrin glue and PGA felt is an effective prophylactic procedure for preventing development of PF after laparoscopic splenectomy.
Authors: Mohammad Gharieb Khirallah; Fouad Hesham Salama; Mohammad Ahmad Arafa; Nagi Ebrahim Eldessoki; Mohammad Elshanshory Journal: J Indian Assoc Pediatr Surg Date: 2019 Jul-Sep
Authors: T Vowinkel; F Becker; A S Mehdorn; A K Schwieters; W A Mardin; N Senninger; B Strücker; A Pascher Journal: Langenbecks Arch Surg Date: 2022-05-04 Impact factor: 2.895