A novel approach for reinforcing the pancreatic remnant in laparoscopic distal pancreatectomy: an experimental study on a porcine model.

The major postoperative complication after open and laparoscopic distal pancreatectomy is pancreatic fistula. Different operative techniques have been tested to minimize this unpleasant complication. We evaluated a new technique for pancreatic stump reinforcement with synthetic glue after laparoscopic distal pancreatectomy. Ten female domestic pigs were divided into 2 groups; in group A (n=5), the pancreas was transected using an EndoGIA stapler, whereas in group B (n=5), the pancreas was transected using a Ligasure device and the pancreatic stump was reinforced with a hydrogel sealant. The clinical postoperative course was uneventful in all the cases. No differences were observed in pancreatic remnant healing between the groups, and only minor microscopic alterations of the healing process were found in the groups. The technique using Ligasure transection reinforced by the hydrogel sealant seems to be comparable with the standard transection technique using the stapler.