title: Systematic review on the use of matrix-bound sealants in pancreatic resection.
abstract: BACKGROUND
  Pancreatic fistula is a potentially life-threatening complication after a pancreatic resection. The aim of this systematic review was to evaluate the role of matrix-bound sealants after a pancreatic resection in terms of preventing or ameliorating the course of a post-operative pancreatic fistula.
  
  
  METHODS
  A systematic search was performed in the literature from May 2005 to April 2015. Included were clinical studies using matrix-bound sealants after a pancreatic resection, reporting a post-operative pancreatic fistula (POPF) according to the International Study Group on Pancreatic Fistula classification, in which grade B and C fistulae were considered clinically relevant.
  
  
  RESULTS
  Two were studies on patients undergoing pancreatoduodenectomy (sealants n = 67, controls n = 27) and four studies on a distal pancreatectomy (sealants n = 258, controls n = 178). After a pancreatoduodenectomy, 13% of patients treated with sealants versus 11% of patients without sealants developed a POPF (P = 0.76), of which 4% versus 4% were clinically relevant (P = 0.87). After a distal pancreatectomy, 42% of patients treated with sealants versus 52% of patients without sealants developed a POPF (P = 0.03). Of these, 9% versus 12% were clinically relevant (P = 0.19).
  
  
  CONCLUSIONS
  The present data do not support the routine use of matrix-bound sealants after a pancreatic resection, as there was no effect on clinically relevant POPF. Larger, well-designed studies are needed to determine the efficacy of sealants in preventing POPF after a pancreatoduodenectomy.
authors: Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
authors: F Jasmijn
authors: FJ
authors: Smits
authors: Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.|Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands.
authors: Hjalmar C
authors: HC
authors: van Santvoort
authors: Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands.
authors: Marc G H
authors: MG
authors: Besselink
authors: Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
authors: Inne H M
authors: IH
authors: Borel Rinkes
authors: Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
authors: I Quintus
authors: IQ
authors: Molenaar
mesh_terms: D006801:Humans; D007432:Intraoperative Period; D010180:Pancreatectomy / Q000379:methods*; D010185:Pancreatic Fistula / Q000517:prevention & control*; D010190:Pancreatic Neoplasms / Q000601:surgery*; D011183:Postoperative Complications / Q000517:prevention & control*; D014014:Tissue Adhesives / Q000627:therapeutic use*
chemical_list: D014014:Tissue Adhesives