Serra Francesco, Bonaduce Isabella, Rossi Elena Giulia, De Ruvo Nicola, Cautero Nicola, Gelmini Roberta
Department of Surgery, University of Modena and Reggio Emilia, Policlinico of Modena, Via del Pozzo, 71 41100, Modena, Italy.
Ann Med Surg (Lond). 2021 Mar 26;64:102244. doi: 10.1016/j.amsu.2021.102244. eCollection 2021 Apr.
POPF derives from the pancreatic stump, which follows pancreatic resection and the pancreatoenteric anastomosis following pancreaticoduodenectomy. Since 1978 sealants have been used in pancreatic surgery to prevent pancreatic fistula after resection of the pancreatic head and tail or for the management of trauma and the treatment of low-output pancreatic fistula. Different types of fibrin sealants have been evaluated for their potential to reduce the occurrence of POPF.
A systematic search of the electronic literature was performed using PubMed, Cochrane Library, and Scopus databases to obtain access to all publications, especially clinical trials, randomised controlled trials, and systematic reviews concerning fibrin sealants pancreatic surgery. Searching for "fibrin sealants pancreas," we found a total of 73 results on Pubmed, 61 on Scopus, and 14 on Cochrane Library (148 total results).
Eighteen studies were found on literature, following the criteria already described, concerning the use of fibrin sealants in pancreatic surgery. All articles described were published in the period between 1989 and 2019.Most of these were single centre studies. A total of 1032 patients were enrolled in this review. In the studies, sealants were used to reinforce pancreatic anastomoses and for the occlusion of the main pancreatic duct.
CR-POPF is a fearful complication of pancreatic surgery; among the possible solutions to reduce the risk of onset, sealants were used on the pancreatic stump; today the sealants should be considered such as an option to reduce the CR-POPF, but the routine use in clinical practice has to be validated.
胰瘘源于胰腺残端，发生于胰腺切除术后以及胰十二指肠切除术后的胰肠吻合术后。自1978年以来，密封剂已被用于胰腺手术，以预防胰头和胰尾切除术后的胰瘘，或用于处理创伤及治疗低流量胰瘘。已对不同类型的纤维蛋白密封剂降低胰瘘发生率的潜力进行了评估。
使用PubMed、Cochrane图书馆和Scopus数据库对电子文献进行系统检索，以获取所有相关出版物，特别是关于纤维蛋白密封剂在胰腺手术中的临床试验、随机对照试验和系统评价。搜索“纤维蛋白密封剂 胰腺”，我们在PubMed上共找到73条结果，在Scopus上找到61条，在Cochrane图书馆上找到14条（总计148条结果）。
根据已描述的标准，在文献中找到了18项关于纤维蛋白密封剂在胰腺手术中应用的研究。所有这些文章均发表于1989年至2019年期间。其中大多数是单中心研究。本综述共纳入1032例患者。在这些研究中，密封剂用于加强胰肠吻合以及封闭主胰管。
临床相关胰瘘是胰腺手术可怕的并发症；在降低发病风险的可能解决方案中，密封剂被用于胰腺残端；如今密封剂应被视为降低临床相关胰瘘的一种选择，但在临床实践中的常规使用有待验证。
