Use of Hemopatch Does Not Prevent Post-Operative Pancreatic Fistula Rates in Distal Pancreatectomies

Abstract

Aims
Many techniques are employed to prevent Post-Operative Pancreatic Fistula (POPF) but these appear largely equivocal. We aimed to determine the effect of Hemopatch use on the incidence of POPF post distal pancreatic resection.

Methods
A retrospective review of a prospectively maintained multi-institutional pancreatic resection database of patients was conducted. Cohorts were divided into those who had a Hemopatch applied to the pancreatic stump and those who did not. Demographics, rates and grade of POPF, peak drain amylase after day 3, complications, and 30 day mortality were analysed. Statistical analysis was conducted using SPSS. Fischer’s test, chi-squared and T-tests were employed with a p-value of <0.05 deemed significant.

Results
Demographics were similar between cohorts. The use of Hemopatch demonstrated a reduction in clinically significant POPF at 2 of 33 (6%) versus 7 of 38 (19%) in the standard group (p-value 0.122). Mean peak drain amylase was 7989IU/L and 1818IU/L in the standard and Hemopatch cohorts respectively (p-value 0.097). Drains remaining in situ for longer than five weeks occurred in five cases of standard DP and zero cases of the Hemopatch cohort (p-value 0.031).

Discussion
The routine use of Hemopatch is a safe adjunct in distal pancreatectomies, but does not reduce rates of POPF.