title: Use of a Fibrinogen/Thrombin-Based Collagen Fleece (TachoComb, TachoSil) With a Stapled Closure to Prevent Pancreatic Fistula Formation Following Distal Pancreatectomy.
abstract: OBJECTIVE
  Postoperative pancreatic fistula formation remains a source of significant morbidity following distal pancreatectomy. The aim of this study was to evaluate the rate of clinically significant fistulas (International Study Group on Pancreatic Fistula grade B and grade C) after distal pancreatectomy using a fibrinogen/thrombin-based collagen fleece (TachoComb, TachoSil) with a stapled closure.
  
  
  METHODS
  Seventy-five patients underwent distal pancreatectomy at our institution between January 2005 and March 2014. A fibrinogen/thrombin-based collagen fleece was applied to the staple line of the pancreas before stapling.
  
  
  RESULTS
  Twenty-six patients (34.7%) developed a pancreatic fistula, 8 patients (10.7%) developed a grade B fistula, and no patients developed a grade C fistula. The duration of the drain was significantly different in patients with or without a pancreatic fistula (8.0 ± 4.5 vs. 5.4 ± 1.3 days, P = .0003). Histological analysis showed that there was a tight covering with the fibrinogen/thrombin-based collagen fleece.
  
  
  CONCLUSIONS
  The fibrinogen/thrombin-based collagen fleece (TachoComb, TachoSil) with a stapled closure has low rates of fistula formation and provides a safe alternative to the conventional stapled technique in distal pancreatectomy.
authors: New-Tokyo Hospital, Chiba, Japan k-mita01@sth-medical.co.jp.
authors: Kazuhito
authors: K
authors: Mita
authors: New-Tokyo Hospital, Chiba, Japan.
authors: Hideto
authors: H
authors: Ito
authors: New-Tokyo Hospital, Chiba, Japan.
authors: Ryo
authors: R
authors: Murabayashi
authors: New-Tokyo Hospital, Chiba, Japan.
authors: Hideki
authors: H
authors: Asakawa
authors: New-Tokyo Hospital, Chiba, Japan.
authors: Masashi
authors: M
authors: Nabetani
authors: New-Tokyo Hospital, Chiba, Japan.
authors: Akira
authors: A
authors: Kamasako
authors: New-Tokyo Hospital, Chiba, Japan.
authors: Kazuya
authors: K
authors: Koizumi
authors: New-Tokyo Hospital, Chiba, Japan.
authors: Takashi
authors: T
authors: Hayashi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D007611:Aprotinin / Q000627:therapeutic use*; D015331:Cohort Studies; D004338:Drug Combinations; D005260:Female; D005340:Fibrinogen / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000473:pathology / Q000601:surgery; D010180:Pancreatectomy / Q000009:adverse effects* / Q000379:methods; D010185:Pancreatic Fistula / Q000517:prevention & control*; D011183:Postoperative Complications / Q000517:prevention & control*; D017792:Surgical Stapling / Q000379:methods*; D013917:Thrombin / Q000627:therapeutic use*
chemical_list: D004338:Drug Combinations; C518955:TachoSil; C093991:tachocomb; D005340:Fibrinogen; D007611:Aprotinin; D013917:Thrombin
keywords: TachoComb; TachoSil; distal pancreatectomy; pancreatic fistula