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Application of Polyethylene Glycolic Acid Felt with Fibrin Sealant to Prevent Postoperative Pancreatic Fistula in Pancreatic Surgery

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

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.

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Authors and Affiliations

  1. Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, 6028566, Japan

    Toshiya Ochiai, Teruhisa Sonoyama, Koji Soga, Koji Inoue, Hisashi Ikoma, Atsushi Shiozaki, Yoshiaki Kuriu, Takeshi Kubota, Masayoshi Nakanishi, Shojiro Kikuchi, Daisuke Ichikawa, Hitoshi Fujiwara, Chouhei Sakakura, Kazuma Okamoto, Yukihito Kokuba & Eigo Otsuji

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  1. Toshiya Ochiai
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  2. Teruhisa Sonoyama
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  3. Koji Soga
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  4. Koji Inoue
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  5. Hisashi Ikoma
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  6. Atsushi Shiozaki
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  13. Chouhei Sakakura
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  14. Kazuma Okamoto
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  15. Yukihito Kokuba
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  16. Eigo Otsuji
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Correspondence to Toshiya Ochiai.

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Ochiai, T., Sonoyama, T., Soga, K. et al. Application of Polyethylene Glycolic Acid Felt with Fibrin Sealant to Prevent Postoperative Pancreatic Fistula in Pancreatic Surgery. J Gastrointest Surg 14, 884–890 (2010). https://doi.org/10.1007/s11605-009-1149-3

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  • DOI: https://doi.org/10.1007/s11605-009-1149-3

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