Related Experiment Video
Updated: May 16, 2026
Application of End-to-end Anastomosis in Robotic Central Pancreatectomy
Published on: June 2, 2018
Safety of a new biological adhesive after pancreatic resection
M Cavallini1, M La Torre, M Ferri
1Surgical Department of Clinical Sciences, Biomedical Technologies and Translational Medicine, Sant'Andrea Hospital, Faculty of Medicine and Psychology University, "La Sapienza" University, Rome, Italy.
Aim:
Pancreatic fistula (PF) represents the main complication (10%-29%) after pancreatic surgery. Soft pancreatic texture with a not dilated pancreatic duct represent the major risk factors for PF. Mortality after pancreaticoduodenectomy (PD) is reported in several large series to be <5%. PF and local sepsis are the main causes of delayed arterial hemorrage with a high mortality rate (14-38%). Therefore, any effort should be implemented in order to reduce the incidence of PF.
Methods:
In the present study we have extended the use of the biological adhesive Bioglue® to coat pancreatic resection surface after distal pancreasectomy (DP, N.=5) and pancreatico-jejunostomy (PJ) after PD (N.=18) in a
Results:
Operative mortality was observed in 2 instances: one case after PJ leakage (1/18, 5.5%) and one case after DP not related to PF (1/5, 20%). PF has been documented in 7/23 (30,4%) after pancreatic resection, and in all cases after PD. In 3 cases PF has been successfully treated conservatively by NPO and octreotide. 2 patients required radiological percutaneous transhepatic biliary drainage and 2 patients required surgical drainage of multiple intrabdominal collections and radiological PTBD.
Conclusion:
On the basis of these observations Bioglue® can be safely utilized to coat pancreatic surface after DP and pancreatico-jejunostomy after PD. This experience warrants further larger controlled studies of the potential value of Bioglue® in reducing the incidence of PF after major pancreatic surgery.
Insights
Bioglue® may reduce pancreatic fistula (PF) after pancreatic surgery. This biological adhesive was applied to pancreatic resection surfaces, showing potential in preventing this common complication.
Area of Science:
- Surgical Innovation
- Gastroenterology
- Biomaterials in Surgery
Background:
- Pancreatic fistula (PF) is a significant complication (10-29%) following pancreatic surgery.
- Risk factors for PF include soft pancreatic texture and non-dilated pancreatic ducts.
- PF contributes to high mortality rates, especially when associated with local sepsis and delayed hemorrhage.
Purpose of the Study:
- To evaluate the safety and efficacy of using Bioglue® to reduce pancreatic fistula after pancreatic surgery.
- To assess the application of Bioglue® in distal pancreatectomy (DP) and pancreatico-jejunostomy (PJ) after pancreaticoduodenectomy (PD).
Main Methods:
- Bioglue® was applied to the pancreatic resection surface in 5 distal pancreatectomies (DP).
- Bioglue® was used for pancreatico-jejunostomy (PJ) in 18 pancreaticoduodenectomies (PD).
Main Results:
- Pancreatic fistula (PF) occurred in 7 out of 23 patients (30.4%), all in the PD group.
- Operative mortality was 5.5% (1/18) after PJ leakage and 20% (1/5) after DP (unrelated to PF).
- Conservative treatment (NPO, octreotide) was successful in 3 PF cases; others required drainage procedures.
Conclusions:
- Bioglue® appears to be safely utilized for coating pancreatic surfaces in DP and PJ after PD.
- Further large-scale, controlled studies are warranted to confirm Bioglue®'s value in reducing PF incidence after major pancreatic surgery.
