Effect of TachoSil Patch in Prevention of Postoperative Pancreatic Fistula

BACKGROUND: Postoperative pancreatic fistula (POPF) is a severe complication after pancreatic resections. The aim was to assess if application of TachoSil® patch could reduce incidence of postoperative fistulas after laparoscopic distal pancreatic resections. METHODS: This is a retrospective study of prospectively collected data after enucleations and distal pancreatic resections. Patients were divided in two groups: with or without application of TachoSil® patch. Demographic and surgical data were analyzed. RESULTS: One hundred twenty-one patients with distal pancreatic resections without additional resections were identified among 230 patients operated by laparoscopic approach at our institution since 1998. They were divided into two groups. In group 1 (n = 48), TachoSil® patch was not applied while in group 2 (n = 73), the pancreatic stump was covered with TachoSil®. Postoperative fistulas were registered in 8% (4/48) and 12% (9/73) in groups 1 and 2, respectively. The median duration of postoperative hospital stay in group 1 was 5.5 (2–35) days compared with 5 (2–16) days in group 2. No significant difference in surgical outcomes was found. CONCLUSIONS: The application of the TachoSil® patch did not affect either occurrence of POPF or duration of postoperative hospital stay. Routine use of TachoSil® patch to prevent pancreatic fistulas does not provide clinically significant benefit.