Bio-absorbable sealants for reinforcing the pancreatic stump after distal pancreatectomy are critical
Abstract: Background
Bio‐absorbable sealants are widely used to reduce the rate and severity of postoperative pancreatic fistulas after distal pancreatectomy. However, numerous clinical trials have failed to demonstrate their clinical benefit. We therefore investigated stability and bio‐compatibility of absorbable sealants in vitro and in vivo.
Methods
In vitro, polymerized compounds were incubated in pancreatic juice before their stability was tested. In vivo, two compounds were used to seal the pancreatic stump after distal pancreatectomy in nine pigs. Burst pressure of the pancreatic stump, surgical outcome, histology of the pancreatic stump, systemic inflammation, and drain fluid was examined.
Results
Products based on fibrin or collagen were unstable in the presence of active pancreatic enzymes and completely dissolved within 2 h. Sealants using chemical cross‐linking of proteins showed improved stability for 7 days. In vivo, application of polyethylenglycol‐based sealant leads to complete closure of the pancreatic duct after 5 days, while a glutaraldehyde‐based sealant prevented physiological closure of the pancreatic main duct.
Conclusions
Many compounds used clinically to reinforce the pancreatic stump after distal pancreatectomy are inadequate due to instability in the presence of pancreatic enzymes. While selected bio‐absorbable sealants inhibited the natural healing of the pancreatic stump, polyethylenglycol‐based sealants should be tested in further clinical trials
- Location
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Deutsche Nationalbibliothek Frankfurt am Main
- Extent
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Online-Ressource
- Language
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Englisch
- Notes
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issn: 1868-6982
- Classification
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Medizin, Gesundheit
- Keyword
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Tierversuch
Pancreas anulare
Polyethylenglykole
- Event
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Veröffentlichung
- (where)
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Freiburg
- (who)
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Universität
- (when)
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2019
- Creator
- DOI
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10.1002/jhbp.604
- URN
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urn:nbn:de:bsz:25-freidok-1494894
- Rights
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Der Zugriff auf das Objekt ist unbeschränkt möglich.
- Last update
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17.08.2025, 2:57 PM CEST
Data provider
Deutsche Nationalbibliothek. If you have any questions about the object, please contact the data provider.
Associated
- Kühlbrey, Christian M.
- Kasper, Steivan
- Chikhladze, Sophia
- Seifert, Gabriel
- Hopt, Ulrich T.
- Fichtner-Feigl, Stefan
- Wittel, Uwe Alexander
- Universität
Time of origin
- 2019
Other Objects (12)
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Comparison of manual sutures and laparoscopic stapler for pancreatic stump closure techniques in robotic distal pancreatectomy: a single-center experience
Preventing clinically relevant pancreatic fistula with combination of linear stapling plus continuous suture of the stump in laparoscopic distal pancreatectomy
Italian survey about intraperitoneal drain use in distal pancreatectomy
Irrigation and passive drainage of pancreatic stump after distal pancreatectomy in high-risk patients: an innovative approach to reduce pancreatic fistula
Individualized procedures for splenic artery dissection during laparoscopic distal pancreatectomy
Preoperative anaemia in distal pancreatectomy: a propensity-score matched analysis
Laparoscopic versus open distal pancreatectomy: a single-institution comparative study
Correction: Italian survey about intraperitoneal drain use in distal pancreatectomy
Laparoscopic Distal Pancreatectomy Following Prior Upper Abdominal Surgery (Pancreatectomy and Prior Surgery)
New method of remnant closure during distal pancreatectomy
Robotic versus laparoscopic distal pancreatectomy in obese patients
Pancreato-jejunostomy versus hand-sewn closure of the pancreatic stump to prevent pancreatic fistula after distal pancreatectomy: a retrospective analysis
Comparison of manual sutures and laparoscopic stapler for pancreatic stump closure techniques in robotic distal pancreatectomy: a single-center experience
Preventing clinically relevant pancreatic fistula with combination of linear stapling plus continuous suture of the stump in laparoscopic distal pancreatectomy
Italian survey about intraperitoneal drain use in distal pancreatectomy
Irrigation and passive drainage of pancreatic stump after distal pancreatectomy in high-risk patients: an innovative approach to reduce pancreatic fistula
Individualized procedures for splenic artery dissection during laparoscopic distal pancreatectomy
Preoperative anaemia in distal pancreatectomy: a propensity-score matched analysis
Laparoscopic versus open distal pancreatectomy: a single-institution comparative study
Correction: Italian survey about intraperitoneal drain use in distal pancreatectomy
Laparoscopic Distal Pancreatectomy Following Prior Upper Abdominal Surgery (Pancreatectomy and Prior Surgery)
New method of remnant closure during distal pancreatectomy
Robotic versus laparoscopic distal pancreatectomy in obese patients
Pancreato-jejunostomy versus hand-sewn closure of the pancreatic stump to prevent pancreatic fistula after distal pancreatectomy: a retrospective analysis
Comparison of manual sutures and laparoscopic stapler for pancreatic stump closure techniques in robotic distal pancreatectomy: a single-center experience
Preventing clinically relevant pancreatic fistula with combination of linear stapling plus continuous suture of the stump in laparoscopic distal pancreatectomy
Italian survey about intraperitoneal drain use in distal pancreatectomy
Irrigation and passive drainage of pancreatic stump after distal pancreatectomy in high-risk patients: an innovative approach to reduce pancreatic fistula
Individualized procedures for splenic artery dissection during laparoscopic distal pancreatectomy
Preoperative anaemia in distal pancreatectomy: a propensity-score matched analysis
Laparoscopic versus open distal pancreatectomy: a single-institution comparative study