Soft coagulation, polyglycolic acid felt, and fibrin glue for prevention of pancreatic fistula after distal pancreatectomy

Surg Today. 2011 Sep;41(9):1224-7. doi: 10.1007/s00595-010-4433-7. Epub 2011 Aug 26.

Abstract

Purpose: To evaluate the effectiveness of using soft coagulation followed by the application of polyglycolic acid (PGA) felt and fibrin glue to prevent pancreatic fistula (PF) after distal pancreatectomy (DP).

Methods: A soft coagulation system was applied on the cut surface of the pancreas after ligating the main pancreatic duct, followed by the application of layers of PGA felt and fibrin glue on the layers, to prevent the development of a PF after DP.

Results: This technique was applied in nine patients, with mean drain amylase levels of 372 ± 296, 185 ± 209, 54 ± 40, and 47 ± 34 IU/l on days 1, 3, 5, and 7, respectively, after DP. Only one patient (11.1%) showed a Grade A PF on day 3 after surgery; none of the other patients developed a fistula.

Conclusions: This technique is an effective prophylactic measure to prevent the development of a PF after DP.

Publication types

  • Evaluation Study

MeSH terms

  • Aged
  • Female
  • Fibrin Tissue Adhesive*
  • Hemostasis, Surgical / methods*
  • Humans
  • Male
  • Middle Aged
  • Pancreatectomy / methods*
  • Pancreatic Fistula / etiology
  • Pancreatic Fistula / prevention & control*
  • Pancreatic Neoplasms / surgery
  • Polyglycolic Acid*
  • Postoperative Complications / prevention & control*
  • Tissue Adhesives*
  • Treatment Outcome

Substances

  • Fibrin Tissue Adhesive
  • Tissue Adhesives
  • Polyglycolic Acid