Serosal Patching with Glubran ® 2 on the Pancreatic Stump for Reducing Postoperative Pancreatic Fistulae After Robot-Assisted Distal Pancreatectomy: A Single-Center Retrospective Study.

Mahamid, Ahmad; Gerszman, Eden; Kazlow, Esther; Abu Shtaya, Aasem; Goldberg, Natalia; Froylich, Dvir; Haddad, Riad

Simple Summary: Postoperative pancreatic fistulae (POPFs) are a significant cause of morbidity following left pancreatectomy. The aim of our retrospective study was to investigate whether adding serosal patching to Glubran®2 sealant application to the pancreatic stump during robot-assisted left pancreatectomy reduces postoperative pancreatic fistulae (POPFs). This study compared six patients receiving Glubran®2 with serosal patching (GSP) to twelve receiving Glubran®2 alone (GNSP). The GSP group showed a significantly lower incidence rate of clinically significant POPFs (grades B/C, p = 0.034) and overall POPFs (all the grades, p = 0.046). The ninety-day morbidity and mortality were similar between the groups. Although our results suggest that combining serosal patching with Glubran®2 sealant reduces POPFs, further research with a larger cohort is needed to confirm these findings and assess long-term impacts on recovery. Our study highlights the potential benefit of this combined approach in mitigating a significant complication of left pancreatectomy. Background: Postoperative pancreatic fistulae (POPFs) are a significant cause of morbidity following left pancreatectomy. We hypothesized that incorporating serosal patching with the application of a synthetic sealant, a modified cyanoacrylate (Glubran®2), to the pancreatic stump, would decrease the incidence rate of clinically significant POPFs. Methods: This is a retrospective study of consecutive patients who underwent robot-assisted left pancreatectomy. The primary outcome was clinically significant POPFs within 90 days of surgery. Secondary outcomes included the incidence rate of POPFs (all the grades), 90-day morbidity, and 90-day mortality. Results: We compared outcomes between Glubran®2 sealant with serosal patching (GSP, n = 6) and Glubran®2 sealant without serosal patching (GNSP, n = 12) groups. The GSP group had significantly lower incidence rates of clinically significant POPFs (grades B/C) (p = 0.034) and overall POPFs (all the grades) (p = 0.046). No significant differences in 90-day postoperative morbidity were observed between the two groups (p = 0.56), and no 90-day mortality occurred in either group. Conclusions: Incorporating serosal patching along with Glubran®2 sealant in the management of the pancreatic stump during left pancreatectomy demonstrates promising results in reducing the incidence rate of clinically significant POPFs. This finding highlights the need for further research with larger sample sizes in order to confirm the observed outcomes and explore the long-term implications for postoperative complications and recovery in patients undergoing this procedure during pancreatic surgery.

PREVENTION of surgical complications; PANCREATIC diseases; PANCREATIC fistula; TREATMENT effectiveness; RETROSPECTIVE studies; DESCRIPTIVE statistics; PANCREATECTOMY; ROBOTICS; ADHESIVES in surgery; COMPARATIVE studies

Cancers, 2025, Vol 17, Issue 3, p502

2072-6694

Academic Journal

10.3390/cancers17030502