• Kazuhito Mita, Hideto Ito, Ryo Murabayashi, Hideki Asakawa, Masashi Nabetani, Akira Kamasako, Kazuya Koizumi, and Takashi Hayashi.
• New-Tokyo Hospital, Chiba, Japan k-mita01@sth-medical.co.jp.
• Surg Innov. 2015 Dec 1; 22 (6): 601-5.

Background/PurposePostoperative pancreatic fistula formation remains a source of significant morbidity following distal pancreatectomy. The aim of this study was to evaluate the rate of clinically significant fistulas (International Study Group on Pancreatic Fistula grade B and grade C) after distal pancreatectomy using a fibrinogen/thrombin-based collagen fleece (TachoComb, TachoSil) with a stapled closure.MethodsSeventy-five patients underwent distal pancreatectomy at our institution between January 2005 and March 2014. A fibrinogen/thrombin-based collagen fleece was applied to the staple line of the pancreas before stapling.ResultsTwenty-six patients (34.7%) developed a pancreatic fistula, 8 patients (10.7%) developed a grade B fistula, and no patients developed a grade C fistula. The duration of the drain was significantly different in patients with or without a pancreatic fistula (8.0 ± 4.5 vs. 5.4 ± 1.3 days, P = .0003). Histological analysis showed that there was a tight covering with the fibrinogen/thrombin-based collagen fleece.ConclusionThe fibrinogen/thrombin-based collagen fleece (TachoComb, TachoSil) with a stapled closure has low rates of fistula formation and provides a safe alternative to the conventional stapled technique in distal pancreatectomy.© The Author(s) 2015.

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