Use of a Fibrinogen/Thrombin-Based Collagen Fleece (TachoComb, TachoSil) With a Stapled Closure to Prevent Pancreatic Fistula Formation Following Distal Pancreatectomy.

Abstract

BACKGROUND/PURPOSE:

Postoperative pancreatic fistula formation remains a source of significant morbidity following distal pancreatectomy. The aim of this study was to evaluate the rate of clinically significant fistulas (International Study Group on Pancreatic Fistula grade B and grade C) after distal pancreatectomy using a fibrinogen/thrombin-based collagen fleece (TachoComb, TachoSil) with a stapled closure.

METHODS:

Seventy-five patients underwent distal pancreatectomy at our institution between January 2005 and March 2014. A fibrinogen/thrombin-based collagen fleece was applied to the staple line of the pancreas before stapling.

RESULTS:

Twenty-six patients (34.7%) developed a pancreatic fistula, 8 patients (10.7%) developed a grade B fistula, and no patients developed a grade C fistula. The duration of the drain was significantly different in patients with or without a pancreatic fistula (8.0 ± 4.5 vs. 5.4 ± 1.3 days, P = .0003). Histological analysis showed that there was a tight covering with the fibrinogen/thrombin-based collagen fleece.

CONCLUSION:

The fibrinogen/thrombin-based collagen fleece (TachoComb, TachoSil) with a stapled closure has low rates of fistula formation and provides a safe alternative to the conventional stapled technique in distal pancreatectomy.

• Authors: Kazuhito Mita, Hideto Ito, Ryo Murabayashi, Hideki Asakawa, Masashi Nabetani, Akira Kamasako, Kazuya Koizumi, Takashi Hayashi
• Journal: Surgical innovation (Surg Innov) Vol. 22 Issue 6 Pg. 601-5 (Dec 2015) ISSN: 1553-3514 [Electronic] United States
• PMID: 25857807 (Publication Type: Journal Article)
• Copyright: © The Author(s) 2015.

Chemical References

• Drug Combinations
• TachoSil
• tachocomb
• Fibrinogen
• Aprotinin
• Thrombin

Topics

• Aged
• Aged, 80 and over
• Aprotinin (therapeutic use)
• Cohort Studies
• Drug Combinations
• Female
• Fibrinogen (therapeutic use)
• Humans
• Male
• Middle Aged
• Pancreas (pathology, surgery)
• Pancreatectomy (adverse effects, methods)
• Pancreatic Fistula (prevention & control)
• Postoperative Complications (prevention & control)
• Surgical Stapling (methods)
• Thrombin (therapeutic use)