[Preliminary results of pancreatic duct occlusion with fibrin glue following resection of the head of the pancreas in protecting the pancreatico-digestive anastomosis].

The insufficiency of the pancreatico-digestive anastomosis as "weak point" of Whipple's operation still is a serious complication carrying a high lethality although surgical techniques improved and experience grew. By means of the pancreas duct occlusion with fibrin sealant we could experimentally as well as clinically develop a simple and effective method in order to protect the pancreatico-digestive anastomosis. Due to a short, maximal 6 days lasting blockade of the exocrine pancreas secretion with fibrin the atrophy respectively the fibrosis of the exocrine lienal pancreas segment was--contrary to the pancreas duct occlusion with prolamin--avoided; also the endocrine function was preserved. Therefore this procedure seems to be the method of choice in the surgery of pancreatic carcinomas and transplants. The fibrin sealant Tissucol was used for the occlusion; because of the high tryptic activity of the pancreatic juice an Aprotinin concentration of 20,000 IU/ml was necessary. We already carried out this procedure successfully in 5 clinical cases with pancreatic carcinomas.