Fibrin glue sealing in pancreatic surgery

Fibrin glue sealing in pancreatic surgery – Tips From Other Journals

Up to one-third of patients undergoing surgical treatment of pancreatic injuries or the performance of pancreaticointestinal anastomoses develop fistulas caused by the release of proteolytic enzymes. Pancreatic fistula formation is a serious complication causing significant morbidity and mortality. Several methods, such as suture techniques and omental patches, have been used with limited success to prevent fistula formation. Kram and colleagues evaluated the safety and efficacy of fibrin glue made from highly concentrated human fibrinogen and clotting factors in preventing fistula formation in patients undergoing pancreatic surgery.

Fifteen patients were included in the study. Ten of these patients required surgery for pancreatic trauma. Surgery was indicated in the other patients because of pancreatic cancer, chronic pancreatitis or pseudocysts.

Fibrin glue was used directly on penetrating injuries and on suture and staple lines. No complications attributable to the glue were observed, and no pancreatic fistulas developed in the patients. Previously, the incidence of pancreatic fistulas after pancreatic surgery for trauma has been reported to be as high as 30 percent.

The authors believe that fibrin glue may become an important adjunct in the prevention of fistula formation after pancreatic surgery. Further studies are needed to confirm these findings. (American Journal of Surgery, April 1991, vol. 161, p. 479.) 1

COPYRIGHT 1991 American Academy of Family Physicians

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