HPB O01 HemopatchTM – A Viable Means of Preventing Post-Operative Pancreatic Fistula, A Multi-Institutional Review

Abstract

Abstract Background Perioperative complications post distal pancreatectomy can be myriad. One of the most common is pancreatic fistula (POPF), with an incidence that can range widely. Many techniques are employed to prevent POPF but these are mainly equivocal. Methods We conducted a retrospective review of a prospectively maintained multi-institutional pancreatic resection database of patients who underwent surgery between 01/01/2018 and 31/12/2022. Cohorts were divided into those who had a HemopatchTM applied to the pancreatic stump and those without. Demographics, POPF Grade A and Grade B/C, peak drain amylase after day 3, complications, and 30-day mortality were analyzed. Statistical analysis was conducted using SPSS. Chi-squared and T-tests were employed with a p-value of <0.05 deemed significant. Results Demographics between the two groups were similar. Mucinous cystic neoplasms and pancreatic adenocarcinoma accounted for the majority of indications for resection. Through the use of HemopatchTM a statistically significant reduction in Grade A POPF was seen (39% vs 63%, p-value 0.04). Grade B/C POPF approached but did not reach statistical significance in difference (6% vs 18%, p-value 0.07). Peak drain amylase was 7989 IU/L in the cohort who did not have a Hemopatch applied while in the cohort who did there was a mean of 1818 IU/L (p-value 0.05). Conclusions The routine use of HemopatchTM is a safe adjunct in distal pancreatectomies. It renders a statistically significant reduction in Grade A POPF. For Grade B/C POPF it approaches but does not meet the threshold for significance. Routine use is advocated while larger prospective trials are undertaken.