Pancreatic fistula after laparoscopic splenectomy in patients with hypersplenism due to liver cirrhosis: effect of fibrin glue and polyglycolic acid felt on prophylaxis of postoperative complications

Norifumi Tsutsumi, Morimasa Tomikawa, Tomohiko Akahoshi, Hirofumi Kawanaka, Mitsuhiko Ota, Yoshihisa Sakaguchi, Tetsuya Kusumoto, Koji Ikejiri, Makoto Hashizume, Yoshihiko Maehara

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background This study aimed to determine the effect of fibrin glue and polyglycolic acid (PGA) felt on prevention of pancreatic fistula (PF) after laparoscopic splenectomy in patients with hypersplenism due to liver cirrhosis. Methods Fifty consecutive patients were enrolled in this prospective study. Twenty-three patients underwent laparoscopic splenectomy with a fibrin sheet (fibrin sheet group). The sealing ability of each treatment was evaluated by an ex vivo pressure test model. Based on the results from ex vivo experiments, 27 patients received prophylaxis using fibrin glue and PGA felt (PGA with fibrin group). The primary endpoint was the incidence of PF. Results Significantly more (5, 22%) patients developed PF in the fibrin sheet group than in the PGA with fibrin group (0%, P =.037). Conclusions Our new application of fibrin glue and PGA felt is an effective prophylactic procedure for preventing development of PF after laparoscopic splenectomy.

Original languageEnglish
Pages (from-to)882-888
Number of pages7
JournalAmerican Journal of Surgery
Volume212
Issue number5
DOIs
Publication statusPublished - Nov 1 2016

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Hypersplenism
Polyglycolic Acid
Pancreatic Fistula
Fibrin Tissue Adhesive
Splenectomy
Fibrin
Liver Cirrhosis
Prospective Studies
Pressure
Incidence

All Science Journal Classification (ASJC) codes

  • Surgery

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Pancreatic fistula after laparoscopic splenectomy in patients with hypersplenism due to liver cirrhosis : effect of fibrin glue and polyglycolic acid felt on prophylaxis of postoperative complications. / Tsutsumi, Norifumi; Tomikawa, Morimasa; Akahoshi, Tomohiko; Kawanaka, Hirofumi; Ota, Mitsuhiko; Sakaguchi, Yoshihisa; Kusumoto, Tetsuya; Ikejiri, Koji; Hashizume, Makoto; Maehara, Yoshihiko.

In: American Journal of Surgery, Vol. 212, No. 5, 01.11.2016, p. 882-888.

Research output: Contribution to journalArticle

Tsutsumi, Norifumi ; Tomikawa, Morimasa ; Akahoshi, Tomohiko ; Kawanaka, Hirofumi ; Ota, Mitsuhiko ; Sakaguchi, Yoshihisa ; Kusumoto, Tetsuya ; Ikejiri, Koji ; Hashizume, Makoto ; Maehara, Yoshihiko. / Pancreatic fistula after laparoscopic splenectomy in patients with hypersplenism due to liver cirrhosis : effect of fibrin glue and polyglycolic acid felt on prophylaxis of postoperative complications. In: American Journal of Surgery. 2016 ; Vol. 212, No. 5. pp. 882-888.
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abstract = "Background This study aimed to determine the effect of fibrin glue and polyglycolic acid (PGA) felt on prevention of pancreatic fistula (PF) after laparoscopic splenectomy in patients with hypersplenism due to liver cirrhosis. Methods Fifty consecutive patients were enrolled in this prospective study. Twenty-three patients underwent laparoscopic splenectomy with a fibrin sheet (fibrin sheet group). The sealing ability of each treatment was evaluated by an ex vivo pressure test model. Based on the results from ex vivo experiments, 27 patients received prophylaxis using fibrin glue and PGA felt (PGA with fibrin group). The primary endpoint was the incidence of PF. Results Significantly more (5, 22{\%}) patients developed PF in the fibrin sheet group than in the PGA with fibrin group (0{\%}, P =.037). Conclusions Our new application of fibrin glue and PGA felt is an effective prophylactic procedure for preventing development of PF after laparoscopic splenectomy.",
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AU - Tsutsumi, Norifumi

AU - Tomikawa, Morimasa

AU - Akahoshi, Tomohiko

AU - Kawanaka, Hirofumi

AU - Ota, Mitsuhiko

AU - Sakaguchi, Yoshihisa

AU - Kusumoto, Tetsuya

AU - Ikejiri, Koji

AU - Hashizume, Makoto

AU - Maehara, Yoshihiko

PY - 2016/11/1

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N2 - Background This study aimed to determine the effect of fibrin glue and polyglycolic acid (PGA) felt on prevention of pancreatic fistula (PF) after laparoscopic splenectomy in patients with hypersplenism due to liver cirrhosis. Methods Fifty consecutive patients were enrolled in this prospective study. Twenty-three patients underwent laparoscopic splenectomy with a fibrin sheet (fibrin sheet group). The sealing ability of each treatment was evaluated by an ex vivo pressure test model. Based on the results from ex vivo experiments, 27 patients received prophylaxis using fibrin glue and PGA felt (PGA with fibrin group). The primary endpoint was the incidence of PF. Results Significantly more (5, 22%) patients developed PF in the fibrin sheet group than in the PGA with fibrin group (0%, P =.037). Conclusions Our new application of fibrin glue and PGA felt is an effective prophylactic procedure for preventing development of PF after laparoscopic splenectomy.

AB - Background This study aimed to determine the effect of fibrin glue and polyglycolic acid (PGA) felt on prevention of pancreatic fistula (PF) after laparoscopic splenectomy in patients with hypersplenism due to liver cirrhosis. Methods Fifty consecutive patients were enrolled in this prospective study. Twenty-three patients underwent laparoscopic splenectomy with a fibrin sheet (fibrin sheet group). The sealing ability of each treatment was evaluated by an ex vivo pressure test model. Based on the results from ex vivo experiments, 27 patients received prophylaxis using fibrin glue and PGA felt (PGA with fibrin group). The primary endpoint was the incidence of PF. Results Significantly more (5, 22%) patients developed PF in the fibrin sheet group than in the PGA with fibrin group (0%, P =.037). Conclusions Our new application of fibrin glue and PGA felt is an effective prophylactic procedure for preventing development of PF after laparoscopic splenectomy.

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