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Maciver A, McCall M, Mihalicz D, et al. The use of bovine pericardial buttress on linear stapler fails to reduce pancreatic fistula incidence in a porcine pancreatic transection model. HPB Surg. 2011;2011:624060doi: 10.1155/2011/624060.
Maciver, A., McCall, M., Mihalicz, D., Al-Adra, D., Pawlick, R., & Shapiro, A. M. (2011). The use of bovine pericardial buttress on linear stapler fails to reduce pancreatic fistula incidence in a porcine pancreatic transection model. HPB surgery : a world journal of hepatic, pancreatic and biliary surgery, 2011624060. https://doi.org/10.1155/2011/624060
Maciver, A, et al. "The use of bovine pericardial buttress on linear stapler fails to reduce pancreatic fistula incidence in a porcine pancreatic transection model." HPB surgery : a world journal of hepatic, pancreatic and biliary surgery vol. 2011 (2011): 624060. doi: https://doi.org/10.1155/2011/624060
Maciver A, McCall M, Mihalicz D, Al-Adra D, Pawlick R, Shapiro AM. The use of bovine pericardial buttress on linear stapler fails to reduce pancreatic fistula incidence in a porcine pancreatic transection model. HPB Surg. 2011;2011:624060. doi: 10.1155/2011/624060. Epub 2011 Oct 25. PMID: 22114365; PMCID: PMC3202096.
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HPB Surg. 2011;2011:624060. doi: 10.1155/2011/624060. Epub 2011 Oct 25.

The use of bovine pericardial buttress on linear stapler fails to reduce pancreatic fistula incidence in a porcine pancreatic transection model.

HPB surgery : a world journal of hepatic, pancreatic and biliary surgery

A Maciver, M McCall, D Mihalicz, D Al-Adra, R Pawlick, A M J Shapiro

Affiliations

  1. Department of Surgery, University of Alberta Hospitals, 2000 College Plaza, 8215-112 Street, Edmonton, Alberta, Canada T6G 2C8.

PMID: 22114365 PMCID: PMC3202096 DOI: 10.1155/2011/624060

Abstract

We investigate the effectiveness of buttressing the surgical stapler to reduce postoperative pancreatic fistulae in a porcine model. As a pilot study, pigs (n = 6) underwent laparoscopic distal pancreatectomy using a standard stapler. Daily drain output and lipase were measured postoperative day 5 and 14. In a second study, pancreatic transection was performed to occlude the proximal and distal duct at the pancreatic neck using a standard stapler (n = 6), or stapler with bovine pericardial strip buttress (n = 6). Results. In pilot study, 3/6 animals had drain lipase greater than 3x serum on day 14. In the second series, drain volumes were not significantly different between buttressed and control groups on day 5 (55.3 ± 31.6 and 29.3 ± 14.2 cc, resp.), nor on day 14 (9.5 ± 4.2 cc and 2.5 ± 0.8 cc, resp., P = 0.13). Drain lipase was not statistically significant on day 5 (3,166 ± 1,433 and 6,063 ± 1,872 U/L, resp., P = 0.25) or day 14 (924 ± 541 and 360 ± 250 U/L). By definition, 3/6 developed pancreatic fistula; only one (control) demonstrating a contained collection arising from the staple line. Conclusion. Buttressed stapler failed to protect against pancreatic fistula in this rigorous surgical model.

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