Annals of Surgery

Skip Navigation LinksHome > June 2012 - Volume 255 - Issue 6 > Mesh Reinforcement of Pancreatic Transection Decreases Incid...
Annals of Surgery:
doi: 10.1097/SLA.0b013e31825659ef
Randomized Controlled Trial

Mesh Reinforcement of Pancreatic Transection Decreases Incidence of Pancreatic Occlusion Failure for Left Pancreatectomy: A Single-Blinded, Randomized Controlled Trial

Hamilton, Nicholas A. MD*; Porembka, Matthew R. MD*; Johnston, Fabian M. MD*; Gao, Feng MD, MPH, PhD; Strasberg, Steven M. MD*; Linehan, David C. MD*; Hawkins, William G. MD*,‡

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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.

Trial Registration: NCT01359410

© 2012 Lippincott Williams & Wilkins, Inc.


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