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. 2015 Nov;17(11):1033-9.
doi: 10.1111/hpb.12472. Epub 2015 Aug 21.

Systematic review on the use of matrix-bound sealants in pancreatic resection

F Jasmijn Smits  1 , Hjalmar C van Santvoort  1   2 , Marc G H Besselink  2 , Inne H M Borel Rinkes  1 , I Quintus Molenaar  1
Affiliations

Systematic review on the use of matrix-bound sealants in pancreatic resection

F Jasmijn Smits et al. HPB (Oxford). 2015 Nov.

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.

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Figures

Figure 1
Figure 1
Flowchart of study selection in a systematic review
See this image and copyright information in PMC

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