Konishi T, Hiraishi M, Kubota K, Bandai Y, Makuuchi M, Idezuki Y. Segmental occlusion of the pancreatic duct with prolamine to prevent fistula formation after distal pancreatectomy.
Ann Surg 1995;
221:165-70. [PMID:
7531967 PMCID:
PMC1234949 DOI:
10.1097/00000658-199502000-00006]
[Citation(s) in RCA: 41] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVE
The authors used prolamine (Ethibloc, Ethicon GmBH, Norderstedt, Germany) for segmental obstruction of the pancreatic duct to prevent pancreatic fistula development after distal pancreatectomy combined with total gastrectomy for gastric malignancies.
SUMMARY BACKGROUND DATA
Although the initial clinical application of prolamine was pancreatic duct obstruction for patients with pancreatitis and undergoing pancreatic transplantation and pancreaticoduodenectomy for pancreatic cancer, there are no reports on prevention of pancreatic fistula formation after distal pancreatectomy.
METHODS
Prolamine (0.2 mL) was injected into the distal segment of the main duct in the remaining pancreata of 51 patients. Small pancreatic ducts on the cut surface, from which prolamine extravasates, were closed by ligation, the main duct was ligated doubly, and the transected pancreatic margin was closed 15 minutes after phenylpropanolamine hydrochloride injection.
RESULTS
No patient developed a pancreatic fistula or the complication of arterial bleeding due to prolonged infection.
CONCLUSION
Segmental obstruction of the pancreatic duct with prolamine is useful for preventing pancreatic fistula development after distal pancreatectomy.
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