Reinforcement of Pancreticojejunostomy Using Polyglycolic Acid Mesh and Fibrin Glue Sealant
Reinforcement of Pancreticojejunostomy Using Polyglycolic Acid Mesh and Fibrin Glue Sealant
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DOI：
10.1097/mpa.0b013e3181f82f55
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发表时间：
2011-01-01
期刊：
影响因子：
2.9
通讯作者：
Kwon, A-Hon
中科院分区：
文献类型：
--
作者：
Satoi, Sohei;Toyokawa, Hideyoshi;Kwon, A-Hon
目的：探讨使用聚乙醇酸（PGA）网片和纤维蛋白胶密封剂对胰空肠吻合术（PJ）进行密闭加固是否可以降低术后胰瘘（POPF）的发生率。方法：研究人群包括 2006 年 9 月至 2010 年 1 月期间连续接受胰十二指肠切除术的 128 名患者。将纤维蛋白胶与 78 名患者（历史对照）进行比较。结果：两组在总体或脓毒症并发症、再次手术或院内死亡的频率上没有显着差异。各组之间 POPF、胃排空延迟或腹内脓肿的发生率没有显着差异。两组之间必要的干预次数没有差异，并且没有发生出血并发症或 POPF 相关死亡。两组术后住院时间中位数相似：13 天（范围，8Y101 天）与 14 天（范围，8Y61 天）。在由胰管直径小于 3 mm 的患者组成的亚组分析中也观察到了类似的结果。结论：这项回顾性单中心研究表明，使用 PGA 网和纤维蛋白胶加固 PJ 吻合对于降低 POPF 频率没有显着益处。
Objectives: To examine whether pressure-tight reinforcement of pancreaticojejunostomy (PJ) using polyglycolic acid (PGA) mesh and fibrin glue sealant can reduce the incidence of postoperative pancreatic fistula (POPF).Methods: The study population included 128 consecutive patients who underwent pancreaticoduodenectomy between September 2006 and January 2010. Postoperative mortality and morbidity among 50 patients who underwent reinforcement of PJ anastomosis using PGA mesh and fibrin glue were compared with 78 patients (historical controls).Results: The 2 groups demonstrated no significant differences in frequencies of overall or septic complications, reoperation, or in-hospital death. No significant difference in the frequency of POPF, delayed gastric emptying, or intra-abdominal abscess was found between groups. There was no difference between the 2 groups in the number of necessary interventions, and no bleeding complications or POPF-related mortality occurred. The median length of postoperative in-hospital stay between the 2 groups was similar: 13 days (range, 8Y101 days) versus 14 days (range, 8Y61 days). Similar findings were observed in a subgroup analysis consisting of patients with a pancreatic duct diameter smaller than 3 mm.Conclusion: This retrospective single-center study showed that reinforcement of PJ anastomosis using PGA mesh and fibrin glue provided no significant benefit in reducing the frequency of POPF.