title: Soft coagulation, polyglycolic acid felt, and fibrin glue for prevention of pancreatic fistula after distal pancreatectomy.
abstract: OBJECTIVE
  To evaluate the effectiveness of using soft coagulation followed by the application of polyglycolic acid (PGA) felt and fibrin glue to prevent pancreatic fistula (PF) after distal pancreatectomy (DP).
  
  
  METHODS
  A soft coagulation system was applied on the cut surface of the pancreas after ligating the main pancreatic duct, followed by the application of layers of PGA felt and fibrin glue on the layers, to prevent the development of a PF after DP.
  
  
  RESULTS
  This technique was applied in nine patients, with mean drain amylase levels of 372 ± 296, 185 ± 209, 54 ± 40, and 47 ± 34 IU/l on days 1, 3, 5, and 7, respectively, after DP. Only one patient (11.1%) showed a Grade A PF on day 3 after surgery; none of the other patients developed a fistula.
  
  
  CONCLUSIONS
  This technique is an effective prophylactic measure to prevent the development of a PF after DP.
authors.affiliation: Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Ikegami
authors.forename: Takashi
authors.initials: T
authors.lastname: Maeda
authors.forename: Hiroto
authors.initials: H
authors.lastname: Kayashima
authors.forename: Eiji
authors.initials: E
authors.lastname: Oki
authors.forename: Tomoharu
authors.initials: T
authors.lastname: Yoshizumi
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Sakaguchi
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Toh
authors.forename: Ken
authors.initials: K
authors.lastname: Shirabe
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Maehara
mesh_terms: D000368:Aged; D005260:Female; D015718:Fibrin Tissue Adhesive; D006488:Hemostasis, Surgical / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy / Q000379:methods*; D010185:Pancreatic Fistula / Q000209:etiology / Q000517:prevention & control*; D010190:Pancreatic Neoplasms / Q000601:surgery; D011100:Polyglycolic Acid; D011183:Postoperative Complications / Q000517:prevention & control*; D014014:Tissue Adhesives; D016896:Treatment Outcome
chemical_list: D015718:Fibrin Tissue Adhesive; D014014:Tissue Adhesives; D011100:Polyglycolic Acid