[Protection of the pancreatico-digestive anastomosis following resection of the head of the pancreas by pancreatic duct occlusion with fibrin (-glue). Animal experiment and clinical experiences].
The pancreatico-digestive anastomosis is especially then endangered by dehiscence when, following resections due to carcinomas, a healthy lienal pancreatic rest has to be connected to the intestine. In the last years the pancreatic duct occlusion (PDO) with Prolamin proved to be possible for the elimination of the disturbing exocrine secretion. Apart from a strong exocrine fibrosis, a deterioration of the endocrine function results too. In animal experiments as well as clinically a simple and effective method for the protection of the pancreatico-digestive anastomosis could be developed by PDO with fibrin sealant (FS). Contrary to PDO with Prolamin a lower-grade, interstitial fibrosis under intact exocrine function is caused due to the short, 6 days at the most lasting blockade of the exocrine pancreatic secretion. Because of the high tryptic activity of the pancreatic juice 20,000 IU/ml Aprotinin were added to the fibrin sealant. So far this method was employed successfully in 36 patients within the scope of Whipple's operations due to pancreatic head carcinomas.
Waclawiczek
H W
HW
I. Chirurgische Abteilung, Landeskrankenanstalten Salzburg.
Lorenz
D
D
D014670:Ampulla of Vater / Q000601:surgery*; D000681:Amylases / Q000097:blood; D000714:Anastomosis, Surgical / Q000379:methods*; D000818:Animals; D007611:Aprotinin / Q000008:administration & dosage*; D001786:Blood Glucose / Q000378:metabolism; D003138:Common Bile Duct Neoplasms / Q000601:surgery*; D003973:Diatrizoate; D004338:Drug Combinations / Q000008:administration & dosage; D004386:Duodenum / Q000601:surgery*; D005176:Factor XIII / Q000008:administration & dosage*; D005227:Fatty Acids; D015718:Fibrin Tissue Adhesive; D005340:Fibrinogen / Q000008:administration & dosage*; D005500:Follow-Up Studies; D006801:Humans; D007328:Insulin / Q000097:blood; D010180:Pancreatectomy / Q000379:methods*; D010183:Pancreatic Ducts / Q000601:surgery*; D010190:Pancreatic Neoplasms / Q000601:surgery*; D011183:Postoperative Complications / Q000517:prevention & control; D011409:Propylene Glycols; D011506:Proteins / Q000008:administration & dosage; D013529:Surgical Wound Dehiscence / Q000517:prevention & control*; D013552:Swine; D013917:Thrombin / Q000008:administration & dosage*; D014014:Tissue Adhesives / Q000008:administration & dosage*; D015028:Zein
D001786:Blood Glucose; D004338:Drug Combinations; D005227:Fatty Acids; D015718:Fibrin Tissue Adhesive; D007328:Insulin; D011409:Propylene Glycols; D011506:Proteins; D014014:Tissue Adhesives; D003973:Diatrizoate; D005340:Fibrinogen; D015028:Zein; D005176:Factor XIII; D007611:Aprotinin; C020481:alcoholic prolamine solution; D000681:Amylases; D013917:Thrombin
Der Schutz der pancreatico-digestiven Anastomose nach Pankreaskopfresektion durch Pankreasgangocclusion mit Fibrin(-kleber). Tierexperimentelle und klinische Erfahrungen.