Fibrin sealants for the prevention of postoperative pancreatic fistula following pancreatic surgery

Lai, Ming-Liang; Zhou, Shi-Yi; He, Sirong; Cheng, Yao; Cheng, Nan‐Sheng; Deng, Yong; Ding, Xiong

doi:10.1002/14651858.cd009621.pub5

Cited by 2 publications

(1 citation statement)

References 86 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“… 33 analysed non-fibrin-based materials. Even when sealants were unable to significantly reduce the POPF rate, some slight effects, especially regarding the treatment of the left pancreatic remnant, were observed, as previously reported 52 . In addition, the present meta-analysis observed a reduction in the number of reoperations after artificial coverage.…”

Section: Discussionsupporting

confidence: 77%

Effect of artificial or autologous coverage of the pancreatic remnant or anastomosis on postoperative pancreatic fistulas after partial pancreatectomy: meta-analysis of randomized clinical trials

Walber,

Antony,

Strothmann

et al. 2024

BJS Open

View full text Add to dashboard Cite

Background Postoperative pancreatic fistulas remain a driver of major complications after partial pancreatectomy. It is unclear whether coverage of the anastomosis or pancreatic remnant can reduce the incidence of postoperative pancreatic fistulas. The aim of this study was to evaluate the effect of autologous or artificial coverage of the pancreatic remnant or anastomosis on outcomes after partial pancreatectomy. Methods A systematic literature search was performed using MEDLINE and the Cochrane Central Register of Controlled Trials (CENTRAL) up to March 2024. All RCTs analysing a coverage method in patients undergoing partial pancreatoduodenectomy or distal pancreatectomy were included. The primary outcome was postoperative pancreatic fistula development. Subgroup analyses for pancreatoduodenectomy or distal pancreatectomy and artificial or autologous coverage were conducted. Results A total of 18 RCTs with 2326 patients were included. In the overall analysis, coverage decreased the incidence of postoperative pancreatic fistulas by 29% (OR 0.71, 95% c.i. 0.54 to 0.93, P < 0.01). This decrease was also seen in the 12 RCTs covering the remnant after distal pancreatectomy (OR 0.69, 95% c.i. 0.51 to 0.94, P < 0.02) and the 4 RCTs applying autologous coverage after pancreatoduodenectomy and distal pancreatectomy (OR 0.53, 95% c.i. 0.29 to 0.96, P < 0.04). Other subgroup analyses (artificial coverage or pancreatoduodenectomy) showed no statistically significant differences. The secondary endpoints of mortality, reoperations, and re-interventions were each affected positively by the use of coverage techniques. The certainty of evidence was very low to moderate. Conclusion The implementation of coverage, whether artificial or autologous, is beneficial after partial pancreatectomy, especially in patients undergoing distal pancreatectomy with autologous coverage.

show abstract

Section: Discussionsupporting

confidence: 77%

Effect of artificial or autologous coverage of the pancreatic remnant or anastomosis on postoperative pancreatic fistulas after partial pancreatectomy: meta-analysis of randomized clinical trials

Walber,

Antony,

Strothmann

et al. 2024

BJS Open

View full text Add to dashboard Cite

show abstract

Principles of minimize bleeding and the transfusion of blood and its components in operated patients – surgical aspects

Banasiewicz,

Machała,

Borejsza Wysocki

et al. 2023

Pol Przegl Chir

View full text Add to dashboard Cite

One of the target of perioperative tratment in surgery is decreasing intraoperative bleeding, which increases the number of perioperative procedures, mortality and treatment costs, and also causes the risk of transfusion of blood and its components. Trying to minimize the blood loss(mainly during the operation) as well as the need to transfuse blood and its components (broadly understood perioperative period) should be standard treatment for a patient undergoing a procedure. In the case of this method, the following steps should be taken: 1) in the preoperative period: identyfication of risk groups as quickly as possible, detecting and treating anemia, applying prehabilitation, modyfying anticoagulant treatment, considering donating one's own blood in some patients and in selected cases erythropoietin preparations; 2) in the perioperative period: aim for normothermia, normovolemia and normoglycemia, use of surgical methods that reduce bleeding, such as minimally invasive surgery, high-energy coagulation, local hemostatics, prevention of surgical site infection, proper transfusion of blood and its components if it occurs; 3) in the postoperative period: monitor the condition of patients, primarily for the detection of bleeding, rapid reoperation if required, suplementation (oral administration preferred) nutrition with microelements (iron) and vitamins, updating its general condition. All these activities, comprehensively and in surgical cooperation with the anesthesiologist, should reduce the blood loss and transfusion of blood and its components.

show abstract

Fibrin sealants for the prevention of postoperative pancreatic fistula following pancreatic surgery

Cited by 2 publications

References 86 publications

Effect of artificial or autologous coverage of the pancreatic remnant or anastomosis on postoperative pancreatic fistulas after partial pancreatectomy: meta-analysis of randomized clinical trials

Effect of artificial or autologous coverage of the pancreatic remnant or anastomosis on postoperative pancreatic fistulas after partial pancreatectomy: meta-analysis of randomized clinical trials

Principles of minimize bleeding and the transfusion of blood and its components in operated patients – surgical aspects

Contact Info

Product

Resources

About