The Application of Fibrin Sealant in Pancreatic Surgery
Well-controlled comparative studies with or without fibrin sealant were conducted to evaluate (a) the effect on prevention of anastomotic insufficiency of pancreaticojejunostomy and (b) the effect on the sealing of small ducts and vessels in the resected surface of the pancreas. A total of 36 patients who had undergone pancreaticojejunostomy were examined, i.e., 16 cases treated with fibrin sealant in anastomosis and 20 cases treated without. A total of 20 cases of distal pancreatectomy were also examined, i.e., ten cases treated with and ten cases treated without fibrin sealant in the resected surface.
The incidence of anastomotic insufficiency was one in 16 with fibrin sealant (6.3 %) and three in 20 without (15.0%); hence, there was a small difference between the two groups. The total incidence of bacterial infection with partial tissue necrosis was one in 16 with (6.3 %) and three in 20 without fibrin sealant (15.0%). Thus, there was a small difference here as well.
In addition, the small amount of leakage of pancreatic juice from the resected surface with or without low-grade infection was studied. The incidences were one in ten with and one in ten without fibrin sealant; hence, no difference was observed between the two groups in this operation.
These data indicate the lower incidences of local complications in relation to most earlier reports and the effectiveness of fibrin sealant in the prevention of leakage of pancreatic juice and for hemostasis.
KeywordsPancreatic Duct Pancreatic Fistula Fibrin Glue Distal Pancreatectomy Pancreatic Juice
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