title: Safety of a new biological adhesive after pancreatic resection.
abstract: OBJECTIVE
  Pancreatic fistula (PF) represents the main complication (10%-29%) after pancreatic surgery. Soft pancreatic texture with a not dilated pancreatic duct represent the major risk factors for PF. Mortality after pancreaticoduodenectomy (PD) is reported in several large series to be <5%. PF and local sepsis are the main causes of delayed arterial hemorrage with a high mortality rate (14-38%). Therefore, any effort should be implemented in order to reduce the incidence of PF.
  
  
  METHODS
  In the present study we have extended the use of the biological adhesive Bioglue® to coat pancreatic resection surface after distal pancreasectomy (DP, N.=5) and pancreatico-jejunostomy (PJ) after PD (N.=18) in a
  
  
  RESULTS
  Operative mortality was observed in 2 instances: one case after PJ leakage (1/18, 5.5%) and one case after DP not related to PF (1/5, 20%). PF has been documented in 7/23 (30,4%) after pancreatic resection, and in all cases after PD. In 3 cases PF has been successfully treated conservatively by NPO and octreotide. 2 patients required radiological percutaneous transhepatic biliary drainage and 2 patients required surgical drainage of multiple intrabdominal collections and radiological PTBD.
  
  
  CONCLUSIONS
  On the basis of these observations Bioglue® can be safely utilized to coat pancreatic surface after DP and pancreatico-jejunostomy after PD. This experience warrants further larger controlled studies of the potential value of Bioglue® in reducing the incidence of PF after major pancreatic surgery.
authors.affiliation: Surgical Department of Clinical Sciences, Biomedical Technologies and Translational Medicine, Sant'Andrea Hospital, Faculty of Medicine and Psychology University, "La Sapienza" University, Rome, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Cavallini
authors.forename: M
authors.initials: M
authors.lastname: La Torre
authors.forename: M
authors.initials: M
authors.lastname: Ferri
authors.forename: V
authors.initials: V
authors.lastname: Vitale
authors.forename: P
authors.initials: P
authors.lastname: Mercantini
authors.forename: M
authors.initials: M
authors.lastname: Dente
authors.forename: V
authors.initials: V
authors.lastname: Ziparo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy / Q000009:adverse effects*; D010185:Pancreatic Fistula / Q000209:etiology* / Q000517:prevention & control*; D010190:Pancreatic Neoplasms / Q000601:surgery; D011506:Proteins
chemical_list: C472676:Bio-glue; D011506:Proteins