How to prevent the postoperative pancreatic fistula with an ethylene vinyl alcohol copolymer (Onyx®): A proposal of a new technique

Annals of Hepato-biliary-pancreatic Surgery
Francesco CrafaGiulio Lombardi

Abstract

Despite the advances in identifying risk factors, improving operative technique, and postoperative patient care, pancreatic leakage after pancreatic resection remains a highly debated topic. The aim of this study is to describe our technique and our initial experience with the intraoperative embolization of the main pancreatic duct with an Ethylene Vinyl Alcohol Copolymer (Onyx®). Two patients of 63 and 64 years underwent pancreaticoduodenectomy for a cholangiocarcinoma of the extrahepatic bile duct and a pancreatic adenocarcinoma, respectively. At the time of pancreatic parenchyma resection, a Wirsung duct was identified and catheterized. A wirsungography was done and then, embolization with Onyx® was carried out under fluoroscopic control. Neither of the patients developed a postoperative pancreatic fistula. They were discharged to home on the 17th and 18th postoperative day, respectively. At the last follow-up, no recurrence was found. The two patients became diabetics; both needed the support of supplementary pancreatic enzymes. To our knowledge, we are the first to describe this technique, which seems safe and reliable. Studies on this subject with more patients are needed to confirm the validity of this procedure.

References

Jan 1, 1989·World Journal of Surgery·V Di CarloG Pozza
Mar 27, 2001·The Journal of Surgical Research·T KyokaneY Nimura
Apr 29, 2009·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Richard D Schulick, Kiyoshi Yoshimura
Aug 21, 2010·RöFo : Fortschritte auf dem Gebiete der Röntgenstrahlen und der Nuklearmedizin·R Adamus NürnbergR W Loose
Nov 9, 2011·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Charles Mahlon VollmerUNKNOWN Pancreatic Surgery Mortality Study Group
Nov 6, 2012·Journal of the American College of Surgeons·Mark P CalleryCharles M Vollmer
Nov 17, 2012·RöFo : Fortschritte auf dem Gebiete der Röntgenstrahlen und der Nuklearmedizin·K-M EberhardtM Sadeghi-Azandaryani
Mar 6, 2013·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Ian Martin, Kenneth Au
Jul 19, 2013·RöFo : Fortschritte auf dem Gebiete der Röntgenstrahlen und der Nuklearmedizin·W UllerW A Wohlgemuth
Sep 16, 2016·Updates in Surgery·Sergio AlfieriGiovanni Battista Doglietto
Jan 4, 2017·Surgery·Claudio BassiUNKNOWN International Study Group on Pancreatic Surgery (ISGPS)

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Citations

Jun 22, 2020·Biomedicine & Pharmacotherapy = Biomédecine & Pharmacothérapie·Zewei WeiXiao Zhu

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