Abstract
Pancreatic fistula is still a troublesome complication after distal pancreatectomy. The purpose of this study was to investigate the potential of a fibrin glue containing protease inhibitor (Ulinastatin; UTI-fibrin glue) to suppress the activation of proteases released by the remnant pancreas and to prevent the occurrence of pancreatic fistula following distal pancreatectomy. Seventy-three patients who underwent distal pancreatectomy for pancreatic disease using an Proximate TL Reloadable Linear Stapler (Ethicon Endo-Surgery, LLC, Caguas, Puerto Rico 00725, USA) were studied retrospectively. There were 38 patients in the UTI-fibrin glue group and 35 in the group without UTI. UTI (10,000 U) was added to fibrin glue (3 ml), which was applied to seal the suture line of the pancreatic stump and the site of ligation of the main pancreatic duct. Post-operative pancreatic fistula occurred in five patients (13.2%) from the UTI-fibrin glue group and 13 patients (37.1%) from the non-UTI group (p<0.05). Although this was not a randomized controlled study, the result suggest the usefulness of UTI-fibrin glue for preventing postoperative fistula after distal panceatectomy.
