Use of Seamguard to prevent pancreatic leak following distal pancreatectomy.
OBJECTIVE
To investigate the use of Seamguard, a bioabsorbable staple line-reinforcement product, to prevent pancreatic leak after distal pancreatectomy.


METHODS
A retrospective study examined 85 consecutive patients undergoing distal pancreatectomy at an academic institution from September 5, 1997, to September 30, 2007.


METHODS
Pancreatic fistula and overall mortality and morbidity.


RESULTS
In February 2004, the use of Seamguard in distal pancreas resections was introduced at our institution. Indications for resection included trauma (11 patients), neoplasms (62 patients), and chronic pancreatitis (12 patients). Pancreatic leak was defined as drain output of 25 mL/d or more 7 days postoperatively with a drain amylase level of 1000 U/L or more. Pancreatic leak occurred in 10 of 38 patients (26%) undergoing conventional resection with suture ligation of the pancreatic duct or nonreinforced stapled resection vs 2 of 47 patients (4%) undergoing staple resection using Seamguard reinforcement. Multivariate analysis showed that use of Seamguard with the stapler independently decreased the risk for pancreatic fistula after distal pancreatectomy (odds ratio, 0.07; 95% confidence interval, 0.01-0.43; P = .01).


CONCLUSIONS
The use of Seamguard is quickly becoming a common adjunct in distal pancreas resections. Our study shows a lower incidence of pancreatic leak after distal pancreatectomy with the use of this staple line-reinforcing product.
Department of Surgery, University of California-Irvine Medical Center, 333 City Blvd W, Orange, CA 92868, USA.
Maki
M
Yamamoto
Michael S
MS
Hayashi
Ninh T
NT
Nguyen
Thang D
TD
Nguyen
Scott
S
McCloud
David K
DK
Imagawa
D020341:Absorbable Implants; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D004146:Dioxanes / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy; D010185:Pancreatic Fistula / Q000453:epidemiology / Q000517:prevention & control; D011100:Polyglycolic Acid / Q000627:therapeutic use*; D012189:Retrospective Studies; D013526:Surgical Mesh; D017792:Surgical Stapling / Q000295:instrumentation*; D016896:Treatment Outcome
D004146:Dioxanes; D011100:Polyglycolic Acid; C443643:trimethylene carbonate