Open AccessCollagen-based biological glue after Appleby operation for advanced gastric cancer
Author(s) -
Gian Luca Baiocchi,
Nazario Portolani,
Federico Gheza,
Stefano Maria Giulini
Publication year - 2011
Publication title -
world journal of gastroenterology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.427
H-Index - 155
eISSN - 2219-2840
pISSN - 1007-9327
DOI - 10.3748/wjg.v17.i35.4044
Subject(s) - medicine , pancreatectomy , pancreatic fistula , surgery , pancreatic cancer , pancreas , dissection (medical) , gastrectomy , cancer , trunk , lymphadenectomy , fistula , ecology , biology
Pancreatic fistula is a common complication of distal pancreatectomy; although various surgical procedures have been proposed, no clear advantage is evident for a single technique. We herein report the case of a 38-year-old patient affected by an advanced gastric carcinoma infiltrating the pancreas body, with extensive nodal metastases involving the celiac trunk, who underwent total gastrectomy with lymphadenectomy, distal pancreatectomy and resection en bloc of the celiac trunk (Appleby operation). At the end of the demolitive phase, the pancreatic stump and the aorta at the level of the celiac ligature were covered with a layer of Tachosil(®), a horse collagen sponge made with human coagulation factors (fibrinogen and thrombin). Presenting this case, we wish to highlight the possible sealing effect of this product and hypothesize a role in preventing pancreatic fistula and postoperative lymphorrhagia from extensive nodal dissection.