Hyaluronate Carboxymethylcellulose-Based Bioresorbable Membrane Facilitates a Two-Stage Pancreaticoduodenectomy: Unnecessarily Necessary?

Excerpt

Yamazaki et al. [1] have presented an interesting retrospective cohort study on the safety and feasibility of the use of a hyaluronate carboxymethylcellulose (HCM)-based bioresorbable membrane to reduce adhesions at the second stage of a two-stage pancreaticoduodenectomy performed 4–8 weeks after the initial resection. The authors have reported reduced adhesions, thereby facilitating the second-stage reconstruction. There was also formation of good granulation tissue around the exteriorised pancreatic fistula despite the presence of the HCM-based membrane. The authors used operative duration and blood loss at the second stage as markers for the efficacy of the HCM-based membrane, but found no difference between the HCM-based membrane group (n = 61) and the historical control group in which the HCM-based membrane was not used (n = 145) in the rate of pancreatic fistula formation. …