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Langenbeck's Archives of Surgery
Published in: Langenbeck's Archives of Surgery 2/2016

01-03-2016 | SYSTEMATIC REVIEW AND META-ANALYSIS

Effectiveness of Tachosil® in the prevention of postoperative pancreatic fistula after distal pancreatectomy: a systematic review and meta-analysis

Authors: Felix J. Hüttner, André L. Mihaljevic, Thilo Hackert, Alexis Ulrich, Markus W. Büchler, Markus K. Diener

Published in: Langenbeck's Archives of Surgery | Issue 2/2016

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Abstract

Purpose

Postoperative pancreatic fistula (POPF) is a frequent and clinically relevant problem after distal pancreatectomy. A variety of methods have been tested in the attempt to prevent POPF, most of them without convincing results.

Methods

A systematic literature search was conducted in PubMed, Embase and the Cochrane Library to identify clinical studies comparing pancreatic stump closure with the addition of Tachosil® to conventional stump closure. The identified studies were critically appraised, and meta-analyses were performed using a random-effects model. Dichotomous data were pooled using odds ratios, and weighted mean differences were calculated for continuous outcomes, together with the corresponding 95 % confidence intervals.

Results

Four studies (two randomised controlled trials and two retrospective clinical studies) reporting data from 738 patients were included in the meta-analysis. Overall POPF, clinically-relevant POPF, mortality, reoperations, intraoperative blood loss and length of hospital stay did not differ significantly between conventional closure and additional covering of the pancreatic stump with Tachosil®. A sensitivity analysis of only randomised controlled trials confirmed the results.

Conclusions

The application of Tachosil® to the pancreatic stump after distal pancreatectomy is a safe procedure but provides no relevant benefit in terms of POPF, mortality, reoperation rate, blood loss or length of hospital stay. Future research should concentrate on novel methods of pancreatic stump closure to prevent POPF after distal pancreatectomy.
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Metadata
Title
Effectiveness of Tachosil® in the prevention of postoperative pancreatic fistula after distal pancreatectomy: a systematic review and meta-analysis
Authors
Felix J. Hüttner
André L. Mihaljevic
Thilo Hackert
Alexis Ulrich
Markus W. Büchler
Markus K. Diener
Publication date
01-03-2016
Publisher
Springer Berlin Heidelberg
Published in
Langenbeck's Archives of Surgery / Issue 2/2016
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI
https://doi.org/10.1007/s00423-016-1382-7

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