Prevention of pancreatic fistula using polyethylene glycolic acid mesh reinforcement around pancreatojejunostomy: the propensity score‐matched analysis
Background Several small‐scale studies have shown that wrapping polyethylene glycolic acid (PGA) mesh around the anastomotic site reinforced pancreaticojejunostomy following pancreatoduodenectomy (PD) with favorable outcomes. This study investigated the efficacy of PGA mesh for reducing postoperativ...
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| Veröffentlicht in: | Journal of hepato-biliary-pancreatic sciences 2017-03, Vol.24 (3), p.169-175 |
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| creator | Kang, Jae Seung Han, Youngmin Kim, Hongbeom Kwon, Wooil Kim, Sun‐Whe Jang, Jin‐Young |
| description | Background
Several small‐scale studies have shown that wrapping polyethylene glycolic acid (PGA) mesh around the anastomotic site reinforced pancreaticojejunostomy following pancreatoduodenectomy (PD) with favorable outcomes. This study investigated the efficacy of PGA mesh for reducing postoperative pancreatic fistula (POPF) and evaluated other risk factors for POPF.
Methods
This study enrolled 464 consecutive patients who underwent PD performed by one surgeon between 2006 and 2015, including a PGA group of 281 patients (60.6%) and a control group of 183 patients (39.4%). All pancreatico‐enteric anastomoses were performed using double‐layered, duct‐to‐mucosa, end‐to‐side pancreaticojejunostomy.
Results
Mean patient age was 63.1 years. The rates of overall (27.0% vs. 37.2%, P = 0.024) and clinically relevant (Grades B, C; 13.9% vs. 24.0%, P = 0.006) POPF were significantly lower in the PGA than in the control group. Following propensity score matching, the rates of clinically relevant POPF (12.6% vs. 22.4%, P = 0.024) and complications (40.2% vs. 63.8%, P |
| doi_str_mv | 10.1002/jhbp.428 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1855789028</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1855789028</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4738-454da3b14b1f06ca7f4c3ad50f4edd9545678021c8e244a312b9302c4b49d72c3</originalsourceid><addsrcrecordid>eNp1kcFqFTEUhoMottSCTyABN26mJpnkJuNOi7VKwS50PWSSM50MmWRMMsrsfIRufT2fxLm2XkHwbM5ZfHz8nB-hp5ScUULYy3Ho5jPO1AN0TNVOVbtGsYeHW_IjdJrzSLapad3U5DE6YooILgU9Rj-uE3yFUFwMOPZ41sEk0MUZ3LtcFq_xkl24wXP0K5Rh9RAA3_jVRL8x2jiLJ8gDTuBCH5OBaZNhneIS7MEWRxiXEHOJ0_oKlwHwnOIMIbuy4mxigp_fbyddzAAW66D9ml1-gh712mc4vd8n6PPF20_nl9XVx3fvz19fVYbLWlVccKvrjvKO9mRntOy5qbUVpOdgbSO42ElFGDUKGOe6pqzbfsAM73hjJTP1CXpx590yfVkgl3Zy2YD3OkBcckuVEFI1hKkNff4POsYlbXn3lBRKUiHYX6FJMecEfTsnN-m0tpS0-8bafWMt_y18di9cugnsAfzTzwZUd8A352H9r6j9cPnmei_8BUVUpKM</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1875871552</pqid></control><display><type>article</type><title>Prevention of pancreatic fistula using polyethylene glycolic acid mesh reinforcement around pancreatojejunostomy: the propensity score‐matched analysis</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Kang, Jae Seung ; Han, Youngmin ; Kim, Hongbeom ; Kwon, Wooil ; Kim, Sun‐Whe ; Jang, Jin‐Young</creator><creatorcontrib>Kang, Jae Seung ; Han, Youngmin ; Kim, Hongbeom ; Kwon, Wooil ; Kim, Sun‐Whe ; Jang, Jin‐Young</creatorcontrib><description>Background
Several small‐scale studies have shown that wrapping polyethylene glycolic acid (PGA) mesh around the anastomotic site reinforced pancreaticojejunostomy following pancreatoduodenectomy (PD) with favorable outcomes. This study investigated the efficacy of PGA mesh for reducing postoperative pancreatic fistula (POPF) and evaluated other risk factors for POPF.
Methods
This study enrolled 464 consecutive patients who underwent PD performed by one surgeon between 2006 and 2015, including a PGA group of 281 patients (60.6%) and a control group of 183 patients (39.4%). All pancreatico‐enteric anastomoses were performed using double‐layered, duct‐to‐mucosa, end‐to‐side pancreaticojejunostomy.
Results
Mean patient age was 63.1 years. The rates of overall (27.0% vs. 37.2%, P = 0.024) and clinically relevant (Grades B, C; 13.9% vs. 24.0%, P = 0.006) POPF were significantly lower in the PGA than in the control group. Following propensity score matching, the rates of clinically relevant POPF (12.6% vs. 22.4%, P = 0.024) and complications (40.2% vs. 63.8%, P < 0.001) remained significantly lower in the PGA group. Multivariate analysis showed that non‐pancreatic disease, greater blood loss, higher body mass index, and non‐application of PGA mesh were significantly associated with the development of clinically relevant POPF.
Conclusions
PGA mesh reinforcement of pancreaticojejunostomy may prevent POPF as well as reducing overall abdominal complications after PD.
HighlightKang and colleagues investigated the efficacy of pancreaticojejunostomy reinforcement with polyethylene glycolic acid mesh in preventing pancreatic fistulas after pancreatoduodenectomy. The rates of postoperative pancreatic fistulas and complications were significantly lower than in the control group, indicating that reinforcement with polyethylene glycolic acid mesh may prevent pancreatic fistulas after pancreatoduodenectomy.</description><identifier>ISSN: 1868-6974</identifier><identifier>EISSN: 1868-6982</identifier><identifier>DOI: 10.1002/jhbp.428</identifier><identifier>PMID: 28054751</identifier><language>eng</language><publisher>Japan: Wiley Subscription Services, Inc</publisher><subject>Anastomosis, Surgical ; Female ; Humans ; Male ; Middle Aged ; Pancreatic fistula ; Pancreatic Fistula - prevention & control ; Pancreaticojejunostomy ; Pancreatoduodenectomy ; Polyethylene glycolic acid ; Polyglycolic Acid - administration & dosage ; Postoperative Complications - prevention & control ; Propensity Score ; Risk Factors ; Surgical Mesh ; Treatment Outcome</subject><ispartof>Journal of hepato-biliary-pancreatic sciences, 2017-03, Vol.24 (3), p.169-175</ispartof><rights>2017 Japanese Society of Hepato‐Biliary‐Pancreatic Surgery</rights><rights>2017 Japanese Society of Hepato-Biliary-Pancreatic Surgery.</rights><rights>2017 Japanese Society of Hepato-Biliary-Pancreatic Surgery</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4738-454da3b14b1f06ca7f4c3ad50f4edd9545678021c8e244a312b9302c4b49d72c3</citedby><cites>FETCH-LOGICAL-c4738-454da3b14b1f06ca7f4c3ad50f4edd9545678021c8e244a312b9302c4b49d72c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fjhbp.428$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fjhbp.428$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28054751$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kang, Jae Seung</creatorcontrib><creatorcontrib>Han, Youngmin</creatorcontrib><creatorcontrib>Kim, Hongbeom</creatorcontrib><creatorcontrib>Kwon, Wooil</creatorcontrib><creatorcontrib>Kim, Sun‐Whe</creatorcontrib><creatorcontrib>Jang, Jin‐Young</creatorcontrib><title>Prevention of pancreatic fistula using polyethylene glycolic acid mesh reinforcement around pancreatojejunostomy: the propensity score‐matched analysis</title><title>Journal of hepato-biliary-pancreatic sciences</title><addtitle>J Hepatobiliary Pancreat Sci</addtitle><description>Background
Several small‐scale studies have shown that wrapping polyethylene glycolic acid (PGA) mesh around the anastomotic site reinforced pancreaticojejunostomy following pancreatoduodenectomy (PD) with favorable outcomes. This study investigated the efficacy of PGA mesh for reducing postoperative pancreatic fistula (POPF) and evaluated other risk factors for POPF.
Methods
This study enrolled 464 consecutive patients who underwent PD performed by one surgeon between 2006 and 2015, including a PGA group of 281 patients (60.6%) and a control group of 183 patients (39.4%). All pancreatico‐enteric anastomoses were performed using double‐layered, duct‐to‐mucosa, end‐to‐side pancreaticojejunostomy.
Results
Mean patient age was 63.1 years. The rates of overall (27.0% vs. 37.2%, P = 0.024) and clinically relevant (Grades B, C; 13.9% vs. 24.0%, P = 0.006) POPF were significantly lower in the PGA than in the control group. Following propensity score matching, the rates of clinically relevant POPF (12.6% vs. 22.4%, P = 0.024) and complications (40.2% vs. 63.8%, P < 0.001) remained significantly lower in the PGA group. Multivariate analysis showed that non‐pancreatic disease, greater blood loss, higher body mass index, and non‐application of PGA mesh were significantly associated with the development of clinically relevant POPF.
Conclusions
PGA mesh reinforcement of pancreaticojejunostomy may prevent POPF as well as reducing overall abdominal complications after PD.
HighlightKang and colleagues investigated the efficacy of pancreaticojejunostomy reinforcement with polyethylene glycolic acid mesh in preventing pancreatic fistulas after pancreatoduodenectomy. The rates of postoperative pancreatic fistulas and complications were significantly lower than in the control group, indicating that reinforcement with polyethylene glycolic acid mesh may prevent pancreatic fistulas after pancreatoduodenectomy.</description><subject>Anastomosis, Surgical</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Pancreatic fistula</subject><subject>Pancreatic Fistula - prevention & control</subject><subject>Pancreaticojejunostomy</subject><subject>Pancreatoduodenectomy</subject><subject>Polyethylene glycolic acid</subject><subject>Polyglycolic Acid - administration & dosage</subject><subject>Postoperative Complications - prevention & control</subject><subject>Propensity Score</subject><subject>Risk Factors</subject><subject>Surgical Mesh</subject><subject>Treatment Outcome</subject><issn>1868-6974</issn><issn>1868-6982</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kcFqFTEUhoMottSCTyABN26mJpnkJuNOi7VKwS50PWSSM50MmWRMMsrsfIRufT2fxLm2XkHwbM5ZfHz8nB-hp5ScUULYy3Ho5jPO1AN0TNVOVbtGsYeHW_IjdJrzSLapad3U5DE6YooILgU9Rj-uE3yFUFwMOPZ41sEk0MUZ3LtcFq_xkl24wXP0K5Rh9RAA3_jVRL8x2jiLJ8gDTuBCH5OBaZNhneIS7MEWRxiXEHOJ0_oKlwHwnOIMIbuy4mxigp_fbyddzAAW66D9ml1-gh712mc4vd8n6PPF20_nl9XVx3fvz19fVYbLWlVccKvrjvKO9mRntOy5qbUVpOdgbSO42ElFGDUKGOe6pqzbfsAM73hjJTP1CXpx590yfVkgl3Zy2YD3OkBcckuVEFI1hKkNff4POsYlbXn3lBRKUiHYX6FJMecEfTsnN-m0tpS0-8bafWMt_y18di9cugnsAfzTzwZUd8A352H9r6j9cPnmei_8BUVUpKM</recordid><startdate>201703</startdate><enddate>201703</enddate><creator>Kang, Jae Seung</creator><creator>Han, Youngmin</creator><creator>Kim, Hongbeom</creator><creator>Kwon, Wooil</creator><creator>Kim, Sun‐Whe</creator><creator>Jang, Jin‐Young</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>201703</creationdate><title>Prevention of pancreatic fistula using polyethylene glycolic acid mesh reinforcement around pancreatojejunostomy: the propensity score‐matched analysis</title><author>Kang, Jae Seung ; Han, Youngmin ; Kim, Hongbeom ; Kwon, Wooil ; Kim, Sun‐Whe ; Jang, Jin‐Young</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4738-454da3b14b1f06ca7f4c3ad50f4edd9545678021c8e244a312b9302c4b49d72c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Anastomosis, Surgical</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Pancreatic fistula</topic><topic>Pancreatic Fistula - prevention & control</topic><topic>Pancreaticojejunostomy</topic><topic>Pancreatoduodenectomy</topic><topic>Polyethylene glycolic acid</topic><topic>Polyglycolic Acid - administration & dosage</topic><topic>Postoperative Complications - prevention & control</topic><topic>Propensity Score</topic><topic>Risk Factors</topic><topic>Surgical Mesh</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kang, Jae Seung</creatorcontrib><creatorcontrib>Han, Youngmin</creatorcontrib><creatorcontrib>Kim, Hongbeom</creatorcontrib><creatorcontrib>Kwon, Wooil</creatorcontrib><creatorcontrib>Kim, Sun‐Whe</creatorcontrib><creatorcontrib>Jang, Jin‐Young</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of hepato-biliary-pancreatic sciences</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kang, Jae Seung</au><au>Han, Youngmin</au><au>Kim, Hongbeom</au><au>Kwon, Wooil</au><au>Kim, Sun‐Whe</au><au>Jang, Jin‐Young</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prevention of pancreatic fistula using polyethylene glycolic acid mesh reinforcement around pancreatojejunostomy: the propensity score‐matched analysis</atitle><jtitle>Journal of hepato-biliary-pancreatic sciences</jtitle><addtitle>J Hepatobiliary Pancreat Sci</addtitle><date>2017-03</date><risdate>2017</risdate><volume>24</volume><issue>3</issue><spage>169</spage><epage>175</epage><pages>169-175</pages><issn>1868-6974</issn><eissn>1868-6982</eissn><abstract>Background
Several small‐scale studies have shown that wrapping polyethylene glycolic acid (PGA) mesh around the anastomotic site reinforced pancreaticojejunostomy following pancreatoduodenectomy (PD) with favorable outcomes. This study investigated the efficacy of PGA mesh for reducing postoperative pancreatic fistula (POPF) and evaluated other risk factors for POPF.
Methods
This study enrolled 464 consecutive patients who underwent PD performed by one surgeon between 2006 and 2015, including a PGA group of 281 patients (60.6%) and a control group of 183 patients (39.4%). All pancreatico‐enteric anastomoses were performed using double‐layered, duct‐to‐mucosa, end‐to‐side pancreaticojejunostomy.
Results
Mean patient age was 63.1 years. The rates of overall (27.0% vs. 37.2%, P = 0.024) and clinically relevant (Grades B, C; 13.9% vs. 24.0%, P = 0.006) POPF were significantly lower in the PGA than in the control group. Following propensity score matching, the rates of clinically relevant POPF (12.6% vs. 22.4%, P = 0.024) and complications (40.2% vs. 63.8%, P < 0.001) remained significantly lower in the PGA group. Multivariate analysis showed that non‐pancreatic disease, greater blood loss, higher body mass index, and non‐application of PGA mesh were significantly associated with the development of clinically relevant POPF.
Conclusions
PGA mesh reinforcement of pancreaticojejunostomy may prevent POPF as well as reducing overall abdominal complications after PD.
HighlightKang and colleagues investigated the efficacy of pancreaticojejunostomy reinforcement with polyethylene glycolic acid mesh in preventing pancreatic fistulas after pancreatoduodenectomy. The rates of postoperative pancreatic fistulas and complications were significantly lower than in the control group, indicating that reinforcement with polyethylene glycolic acid mesh may prevent pancreatic fistulas after pancreatoduodenectomy.</abstract><cop>Japan</cop><pub>Wiley Subscription Services, Inc</pub><pmid>28054751</pmid><doi>10.1002/jhbp.428</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Anastomosis, Surgical Female Humans Male Middle Aged Pancreatic fistula Pancreatic Fistula - prevention & control Pancreaticojejunostomy Pancreatoduodenectomy Polyethylene glycolic acid Polyglycolic Acid - administration & dosage Postoperative Complications - prevention & control Propensity Score Risk Factors Surgical Mesh Treatment Outcome |
| title | Prevention of pancreatic fistula using polyethylene glycolic acid mesh reinforcement around pancreatojejunostomy: the propensity score‐matched analysis |
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