文章：

使用Glubran®2对胰腺残端进行浆膜补片以降低机器人辅助远端胰腺切除术后胰瘘发生率：一项单中心回顾性研究

Serosal Patching with Glubran®2 on the Pancreatic Stump for Reducing Postoperative Pancreatic Fistulae After Robot-Assisted Distal Pancreatectomy: A Single-Center Retrospective Study

原文发布日期：3 February 2025

DOI: 10.3390/cancers17030502

类型: Article

开放获取: 是

英文摘要：

Background: Postoperative pancreatic fistulae (POPFs) are a significant cause of morbidity following left pancreatectomy. We hypothesized that incorporating serosal patching with the application of a synthetic sealant, a modified cyanoacrylate (Glubran®2), to the pancreatic stump, would decrease the incidence rate of clinically significant POPFs. Methods: This is a retrospective study of consecutive patients who underwent robot-assisted left pancreatectomy. The primary outcome was clinically significant POPFs within 90 days of surgery. Secondary outcomes included the incidence rate of POPFs (all the grades), 90-day morbidity, and 90-day mortality. Results: We compared outcomes between Glubran®2 sealant with serosal patching (GSP,n= 6) and Glubran®2 sealant without serosal patching (GNSP,n= 12) groups. The GSP group had significantly lower incidence rates of clinically significant POPFs (grades B/C) (p= 0.034) and overall POPFs (all the grades) (p= 0.046). No significant differences in 90-day postoperative morbidity were observed between the two groups (p= 0.56), and no 90-day mortality occurred in either group. Conclusions: Incorporating serosal patching along with Glubran®2 sealant in the management of the pancreatic stump during left pancreatectomy demonstrates promising results in reducing the incidence rate of clinically significant POPFs. This finding highlights the need for further research with larger sample sizes in order to confirm the observed outcomes and explore the long-term implications for postoperative complications and recovery in patients undergoing this procedure during pancreatic surgery.

摘要翻译： 

背景：术后胰瘘是左半胰腺切除术后发病的重要原因。我们假设，在胰腺残端应用改良氰基丙烯酸酯合成密封剂（Glubran®2）并结合浆膜补片技术，能够降低具有临床意义的术后胰瘘发生率。方法：本研究对连续接受机器人辅助左半胰腺切除术的患者进行回顾性分析。主要结局指标为术后90天内具有临床意义的胰瘘发生率。次要结局指标包括各级别胰瘘总发生率、术后90天并发症发生率及死亡率。结果：我们比较了Glubran®2联合浆膜补片组（GSP组，n=6）与单纯Glubran®2组（GNSP组，n=12）的临床结局。GSP组在具有临床意义的B/C级胰瘘发生率（p=0.034）及总体胰瘘发生率（p=0.046）方面均显著降低。两组术后90天并发症发生率无显著差异（p=0.56），且均未发生90天内死亡病例。结论：在左半胰腺切除术中，采用Glubran®2密封剂联合浆膜补片技术处理胰腺残端，在降低具有临床意义的术后胰瘘发生率方面展现出良好前景。这一发现提示，未来需要通过更大样本量的研究来验证观察结果，并深入探讨该技术对胰腺手术患者术后并发症及长期康复的影响。

原文链接：

Serosal Patching with Glubran®2 on the Pancreatic Stump for Reducing Postoperative Pancreatic Fistulae After Robot-Assisted Distal Pancreatectomy: A Single-Center Retrospective Study