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Augmenting pancreatic anastomosis during whipple operation with fibrin glue: a beneficial technical modification?
Author(s) -
Conaglen Paul J.,
Collier Neil A.
Publication year - 2014
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/ans.12072
Subject(s) - medicine , fibrin glue , glue , anastomosis , whipple procedure , surgery , general surgery , pancreaticoduodenectomy , mechanical engineering , resection , engineering
Various techniques have been described to try and reduce the rate of anastomotic leak following pancreaticoduodenectomy, which remains a challenge for pancreatic surgeons worldwide. We outline a technique to reinforce the pancreatic anastomosis with a double layer of fibrin glue between suture lines. Methods Our technique for pancreatic anastomosis is described in detail. A review of consecutive pancreaticoduodenectomies by a single surgeon ( NAC ) since introduction of fibrin glue anastomosis reinforcement was compared with a historical control cohort performed by the same surgeon. Results Thirty‐two consecutive pancreaticoduodenectomies were undertaken between M arch 2008 and M arch 2012 by a single surgeon, 30 patients had fibrin glue augmentation of the pancreatico‐gastrostomy anastomosis. Median length of stay was 12 days. There were no pancreatic leaks or mortality since adopting fibrin glue for the pancreatic anastomosis; however; this single surgeon series is not large enough to provide statistical evidence of a difference since glue was adopted. Discussion Our results since the incorporation of this step in pancreaticoduodenectomy are encouraging. Selective use of glue is worthy of consideration in difficult cases, although confirmation of a reduction in pancreatic leak rate is not yet established, and we advocate a multi‐institution randomized controlled trial to explore this.