Indications for Fibrin Sealing in Pancreatic Surgery with Special Regard to Occlusion of a Nonanastomosed Stump with Fibrin Sealant

  • A. P. Marczell
Conference paper

Abstract

In surgery of the pancreas, the rate of complications is high due to the specific properties of pancreatic surgery. A report on a new method, used in over 200 cases, proves that fibrin sealant can significantly reduce the complication rate; especially in the Whipple procedure for malignancies, results were improved by

occlusion of the pancreatic stump with fibrin sealant. Among 67 patients treated with this method, there were no perioperative deaths and four patients developed local complications (three fistulae, one pancreatitis) due to technical errors that presumably resulted in incomplete occlusion. The long-term results with regard to endocrine function are satisfactory.

Keywords

Sugar Catheter Adenocarcinoma Pancreatitis Peri 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Bodner E (1981) Chirurgie des Pankreas: Das Pankreaskarzinom. Acta Chir Austriaca 13: 94Google Scholar
  2. 2.
    Hicks RE, Brooks JR (1971) Total pancreatectomy for ductal carcinoma. Surg Gynecol Obstet 133: 16PubMedGoogle Scholar
  3. 3.
    Trede M, Hoffmeister AW (1982) Chirurgische Therapie des Pankreaskarzinoms. Therapiewoche 32: 918Google Scholar
  4. 4.
    Gebhardt C, Stolte M (1978) Die Ausschaltung des exkretorischen Pankreasparenchyms durch intraduktale Injektion einer schnell härtenden Aminosäurelösung. Chirurg 49: 428PubMedGoogle Scholar
  5. 5.
    Speisberg F, Heberer G, Landgraf R, Wirsching R (1978) Klinik, Diagnostik und Behandlung des organischen Hyperinsulinismus. Munch Med Wochenschr 120: 547Google Scholar
  6. 6.
    Frick S (1982) Komplikationen nach resezierenden Eingriffen bei chronischer Pankreatitis. Langenbecks Arch Chir 356: 82CrossRefGoogle Scholar
  7. 7.
    Rückert K., Kümmerle F (1979) Das Papillenca. Chirurg 50: 308PubMedGoogle Scholar
  8. 8.
    Scheele J (1982) Klinische Erfahrungen mit der Fibrinklebung an parenchymatösen Oberbauchorganen. Aktuel Chir 17: 153Google Scholar
  9. 9.
    Schapiro TM (1975) Adenocarcinoma of the pancreas: a statistical analysis of biliary bypass vs Whipple resection in good risk patients. Ann Surg 182: 715–721CrossRefGoogle Scholar
  10. 10.
    Nakase A, Honjo I, Matsumoto Y, Uchida K (1977) Surgical treatment of cancer of the pancreas and the periampullary region. Ann Surg 185: 52PubMedCrossRefGoogle Scholar
  11. 11.
    Warren KW, Armendariz R, Basu S, Christoph C (1983) Current trends in the diagnosis and treatment of carcinoma of the pancreas. Am J Surg 145: 813–818PubMedCrossRefGoogle Scholar
  12. 12.
    Kümmerle F, Rückert K (1984) Surgical treatment of pancreatic cancer. World J Surg 8: 889–894PubMedCrossRefGoogle Scholar
  13. 13.
    Van Heerden JA (1984) Pancreatic resection for carcinoma of the pancreas: whipple versus total pancreatectomy — an institutional perspective. World J Surg 8: 880–888PubMedCrossRefGoogle Scholar
  14. 14.
    Grace PA, Denbentsen L, Longmire WP, Pitt HA, Tompkins RK (1986) Decreased morbidity and mortality after pancreatoduodenoectomy. Am J Surg 151: 141–148PubMedCrossRefGoogle Scholar
  15. 15.
    Tarazi RY, Esselstyn jr CB, Hermann RE, Hoerr SO, Vogt DP (1986) Results of surgical treatment of periampullary tumors: a thirty-five-year experience. Surgery 100: 716–722PubMedGoogle Scholar
  16. 16.
    Christ DW, Cameron JL, Sitzmann JV (1987) Improved hospital morbidity, mortality, and survival after the Whipple procedure. Ann Surg 206: 358–365CrossRefGoogle Scholar
  17. 17.
    Trede M, Schwall G (1988) The complications of pancreatectomy. Ann Surg 207: 39–47PubMedCrossRefGoogle Scholar
  18. 18.
    Warshaw AL, Swanson RS (1988) Pancreatic cancer in 1988. Possibilities and probabilities. Ann Surg 208: 541–552CrossRefGoogle Scholar
  19. 19.
    Funovics S, Wenzl E (1985) Duodenopankreatektomie: Anastomosierung nicht notwendig. Langenbecks Arch Chir 366: 613CrossRefGoogle Scholar
  20. 20.
    Schopohl J, Droese K, Zöckler CE (1986) Ein modifiziertes Whipple’sches Operationsverfahren. Chirurg 57: 517PubMedGoogle Scholar
  21. 21.
    Marczell A (1986) The use of Tissucol in pancreatic surgery. In: Schlag G, Redl W (eds) General surgery and abdominal surgery. Springer, Berlin Heidelberg New York, p 140 (Fibrin sealant in operative medicine, vol 6)Google Scholar
  22. 22.
    Zirngibl H, Faszbender D, Gebhardt C (1983) Drainagebehandlung von Pankreaspseudozysten. Langenbecks Arch Chir 360: 19CrossRefGoogle Scholar
  23. 23.
    Ascherl R, Blümel G, Geissdörfer K, Hirmer H, Richling B (1985) Pankreasgangokklusion mit Fibrin, 102nd Meeting of the Deutsche Gesellschaft für ChirurgieGoogle Scholar
  24. 24.
    Grossner D, Berkhoff M, Klapder F, Klöppel G, Von Koge H (1989) Insulinreserve und Morphologie des Pankreasschwanzes nach Pankreaskopfresektion bei unterschiedlichen Methoden der Versorgung. Langenbecks Arch Chir 374: 4–11Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1994

Authors and Affiliations

  • A. P. Marczell

There are no affiliations available

Personalised recommendations