Securing Pancreatodigestive Anastomoses with Fibrin Sealant

Because of the high rate of postoperative fistulas after partial duodenopancreatec-tomy, the most important cause of postoperative death, we attempted to diminish the high postoperative mortality by securing the pancreatodigestive anastomosis with fibrin sealant in 23 patients. Because of anastomotic leakage in four patients (17%), an early relaparotomy was necessary, but only in one case was fibrin sealant detected near the anastomosis. The total mortality after Whipple’s procedure was 17%. Although statistically not completely meaningful, these results were compared retrospectively with earlier results at our Clinic on the rates for anastomotic insufficiency, relaparotomy, and mortality. We achieved a significantly lower rate of dehiscence (p < 0.1) and an insignificantly diminished rate of relaparotomy and mortality.