Tillmann Laura-Christin, Herzog Torsten, Uhl Waldemar, Belyaev Orlin
Department of Surgery, St. Josef Hospital, Ruhr University Bochum, Gudrunstr. 56, 44791, Bochum, Germany.
World J Surg. 2017 Jun;41(6):1601-1609. doi: 10.1007/s00268-017-3883-0.
This study aimed to evaluate the effect of a new combined method of covering the pancreatic anastomosis or stump with a cyanoacrylate and a falciform patch (CAFP) on the occurrence of postoperative pancreatic fistula (POPF).
Patients undergoing a pancreaticoduodenectomy (PD) or a distal pancreatectomy (DP) were recruited over a period of 12 months. The pancreaticojejunostomy in PD and the stump in DP were sealed with cyanoacrylate glue and wrapped in a falciform patch. Incidence and severity of POPF and associated postoperative complications were retrospectively compared with historical controls of 750 PD and 336 DP at the same institution and with current data from the literature.
The new method was applied in 27 PD and 25 DP. The rate of clinically relevant POPF after PD with CAFP was 22.2% compared to 14.4% in historical patients, p = 0.26. The rate of clinically relevant POPF after DP with CAFP was 36% compared to 30% in historical patients, p = 0.65.
Sealing the pancreatic anastomosis or stump with a combination of a cyanoacrylate glue and a falciform patch didn't reduce the rate of POPF after major pancreatic resections.
本研究旨在评估一种用氰基丙烯酸酯和镰状补片（CAFP）覆盖胰腺吻合口或残端的新联合方法对术后胰瘘（POPF）发生率的影响。
在12个月的时间里招募接受胰十二指肠切除术（PD）或胰腺远端切除术（DP）的患者。PD中的胰空肠吻合口和DP中的残端用氰基丙烯酸酯胶密封，并用镰状补片包裹。回顾性比较POPF的发生率和严重程度以及相关术后并发症与同一机构750例PD和336例DP的历史对照以及来自文献的当前数据。
新方法应用于27例PD和25例DP。采用CAFP的PD术后临床相关POPF发生率为22.2%，而历史患者为14.4%，p = 0.26。采用CAFP的DP术后临床相关POPF发生率为36%，而历史患者为30%，p = 0.65。
用氰基丙烯酸酯胶和镰状补片联合密封胰腺吻合口或残端并不能降低主要胰腺切除术后POPF的发生率。
