Reduction in Post-operative Pancreatic Fistula with Polyethylene Glycol and Recombinant Human Albumin Sealant Following Stapled Distal Pancreatectomy

Purpose: Postoperative pancreatic fistula (POPF) remains a significant cause of morbidity in patients undergoing distal pancreatectomy (DP). Various methods treating the remnant pancreas have been evaluated however few shown reductions POPF rates. The aim this study is to assess if use polyethylene glycol (PEG) sealant gel applied transected margin DP reduces Method: A retrospective single centre cohort at an Australian high volume tertiary institution between January 2015 and 2021. historical control group was compared with intervention (PEG group) managed standard technique. Pancreatic transection performed non-reinforced Endo GIATM Black 60 mm tri-stapler (4.0mm – 5.0mm). Following transection, 4 ml polyethelene glycol-based adhesive, mixed human albumin (ProgelTM) staple line. Results: 54 cases were identified for analysis, 16 PEG group. majority had stapled 92% (35 38), approximately half 47% (18 38) combined reinforcing buttress, or without other glue types. 28 (52%) developed POPF, significantly lower rate (3 vs. 25 38 Control group; P = 0.003). Clinically Grade B/C (0 9 0.045. Patients shorter median (interquartile range) length hospital stay (6 [4–14] days versus 10 [6–41] 0.04). Conclusion: reduction clinically extremely promising warrants further prospective assessment validation. An investigator led multicentre randomised controlled trial using setting currently underway validate findings study.