Mesh reinforcement of pancreatic transection decreases incidence of pancreatic occlusion failure for left pancreatectomy

A single-blinded, randomized controlled trial

Nicholas Hamilton, Matthew R. Porembka, Fabian M. Johnston, Feng Gao, Steven M. Strasberg, David C. Linehan, William G. Hawkins

Research output: Contribution to journalArticle

68 Citations (Scopus)

Abstract

Introduction: Pancreatic leak or fistula is the most frequent complication after left pancreatectomy. We performed a single-blinded, parallel-group, randomized controlled trial comparing stapled left pancreatectomy with stapled left pancreatectomy using mesh reinforcement of the staple line with either Seamguard or Peristrips Dry. Methods: All patients undergoing left pancreatectomy at a large tertiary hospital were eligible for participation. Patients were randomized to either mesh reinforcement or no-mesh reinforcement intraoperatively after being determined a candidate for resection. Patients were blinded to the result of their randomization for 6 weeks. Primary outcome measure was clinically significant leak as defined by the ISGPF (International Study Group on Pancreatic Fistula) pancreatic leak grading system. Results: One hundred patients were randomized to either mesh (54) or no-mesh (46) reinforcement of their pancreatic transection. There was 1 death in each group. ISGPF grade B and C leaks were seen in 1.9% (1/53) of patients undergoing resection with mesh reinforcement and 20% (11/45) of patients without mesh reinforcement (P = .0007). Conclusions: Mesh reinforcement of pancreatic transection line significantly reduces the incidence of significant pancreatic fistula in patients undergoing left pancreatectomy.

Original languageEnglish (US)
Pages (from-to)1037-1042
Number of pages6
JournalAnnals of Surgery
Volume255
Issue number6
DOIs
StatePublished - Jun 2012
Externally publishedYes

Fingerprint

Pancreatectomy
Randomized Controlled Trials
Pancreatic Fistula
Incidence
Random Allocation
Tertiary Care Centers
Fistula
Outcome Assessment (Health Care)

ASJC Scopus subject areas

  • Surgery

Cite this

Mesh reinforcement of pancreatic transection decreases incidence of pancreatic occlusion failure for left pancreatectomy : A single-blinded, randomized controlled trial. / Hamilton, Nicholas; Porembka, Matthew R.; Johnston, Fabian M.; Gao, Feng; Strasberg, Steven M.; Linehan, David C.; Hawkins, William G.

In: Annals of Surgery, Vol. 255, No. 6, 06.2012, p. 1037-1042.

Research output: Contribution to journalArticle

Hamilton, Nicholas ; Porembka, Matthew R. ; Johnston, Fabian M. ; Gao, Feng ; Strasberg, Steven M. ; Linehan, David C. ; Hawkins, William G. / Mesh reinforcement of pancreatic transection decreases incidence of pancreatic occlusion failure for left pancreatectomy : A single-blinded, randomized controlled trial. In: Annals of Surgery. 2012 ; Vol. 255, No. 6. pp. 1037-1042.
@article{459b8026bf0d45ec9a91ec2e6e79c687,
title = "Mesh reinforcement of pancreatic transection decreases incidence of pancreatic occlusion failure for left pancreatectomy: A single-blinded, randomized controlled trial",
abstract = "Introduction: Pancreatic leak or fistula is the most frequent complication after left pancreatectomy. We performed a single-blinded, parallel-group, randomized controlled trial comparing stapled left pancreatectomy with stapled left pancreatectomy using mesh reinforcement of the staple line with either Seamguard or Peristrips Dry. Methods: All patients undergoing left pancreatectomy at a large tertiary hospital were eligible for participation. Patients were randomized to either mesh reinforcement or no-mesh reinforcement intraoperatively after being determined a candidate for resection. Patients were blinded to the result of their randomization for 6 weeks. Primary outcome measure was clinically significant leak as defined by the ISGPF (International Study Group on Pancreatic Fistula) pancreatic leak grading system. Results: One hundred patients were randomized to either mesh (54) or no-mesh (46) reinforcement of their pancreatic transection. There was 1 death in each group. ISGPF grade B and C leaks were seen in 1.9{\%} (1/53) of patients undergoing resection with mesh reinforcement and 20{\%} (11/45) of patients without mesh reinforcement (P = .0007). Conclusions: Mesh reinforcement of pancreatic transection line significantly reduces the incidence of significant pancreatic fistula in patients undergoing left pancreatectomy.",
author = "Nicholas Hamilton and Porembka, {Matthew R.} and Johnston, {Fabian M.} and Feng Gao and Strasberg, {Steven M.} and Linehan, {David C.} and Hawkins, {William G.}",
year = "2012",
month = "6",
doi = "10.1097/SLA.0b013e31825659ef",
language = "English (US)",
volume = "255",
pages = "1037--1042",
journal = "Annals of Surgery",
issn = "0003-4932",
publisher = "Lippincott Williams and Wilkins",
number = "6",

}

TY - JOUR

T1 - Mesh reinforcement of pancreatic transection decreases incidence of pancreatic occlusion failure for left pancreatectomy

T2 - A single-blinded, randomized controlled trial

AU - Hamilton, Nicholas

AU - Porembka, Matthew R.

AU - Johnston, Fabian M.

AU - Gao, Feng

AU - Strasberg, Steven M.

AU - Linehan, David C.

AU - Hawkins, William G.

PY - 2012/6

Y1 - 2012/6

N2 - Introduction: Pancreatic leak or fistula is the most frequent complication after left pancreatectomy. We performed a single-blinded, parallel-group, randomized controlled trial comparing stapled left pancreatectomy with stapled left pancreatectomy using mesh reinforcement of the staple line with either Seamguard or Peristrips Dry. Methods: All patients undergoing left pancreatectomy at a large tertiary hospital were eligible for participation. Patients were randomized to either mesh reinforcement or no-mesh reinforcement intraoperatively after being determined a candidate for resection. Patients were blinded to the result of their randomization for 6 weeks. Primary outcome measure was clinically significant leak as defined by the ISGPF (International Study Group on Pancreatic Fistula) pancreatic leak grading system. Results: One hundred patients were randomized to either mesh (54) or no-mesh (46) reinforcement of their pancreatic transection. There was 1 death in each group. ISGPF grade B and C leaks were seen in 1.9% (1/53) of patients undergoing resection with mesh reinforcement and 20% (11/45) of patients without mesh reinforcement (P = .0007). Conclusions: Mesh reinforcement of pancreatic transection line significantly reduces the incidence of significant pancreatic fistula in patients undergoing left pancreatectomy.

AB - Introduction: Pancreatic leak or fistula is the most frequent complication after left pancreatectomy. We performed a single-blinded, parallel-group, randomized controlled trial comparing stapled left pancreatectomy with stapled left pancreatectomy using mesh reinforcement of the staple line with either Seamguard or Peristrips Dry. Methods: All patients undergoing left pancreatectomy at a large tertiary hospital were eligible for participation. Patients were randomized to either mesh reinforcement or no-mesh reinforcement intraoperatively after being determined a candidate for resection. Patients were blinded to the result of their randomization for 6 weeks. Primary outcome measure was clinically significant leak as defined by the ISGPF (International Study Group on Pancreatic Fistula) pancreatic leak grading system. Results: One hundred patients were randomized to either mesh (54) or no-mesh (46) reinforcement of their pancreatic transection. There was 1 death in each group. ISGPF grade B and C leaks were seen in 1.9% (1/53) of patients undergoing resection with mesh reinforcement and 20% (11/45) of patients without mesh reinforcement (P = .0007). Conclusions: Mesh reinforcement of pancreatic transection line significantly reduces the incidence of significant pancreatic fistula in patients undergoing left pancreatectomy.

UR - http://www.scopus.com/inward/record.url?scp=84861382171&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84861382171&partnerID=8YFLogxK

U2 - 10.1097/SLA.0b013e31825659ef

DO - 10.1097/SLA.0b013e31825659ef

M3 - Article

VL - 255

SP - 1037

EP - 1042

JO - Annals of Surgery

JF - Annals of Surgery

SN - 0003-4932

IS - 6

ER -