Evidence map›Paper›PMID 30589508›Full record

ArticleJournal of hepato-biliary-pancreatic sciences2019

Bio-absorbable sealants for reinforcing the pancreatic stump after distal pancreatectomy are critical.

Christian M Kühlbrey, Steivan Kasper, Sophia Chikhladze, Gabriel Seifert, Ulrich T Hopt, Stefan Fichtner-Feigl, Uwe A Wittel

Open access · hybridAbstract readEvaluation Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of hepato-biliary-pancreatic sciences, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
0.2field-weighted citation impact, top 40% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 13 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Article
  4. Article
  5. Article
  6. The using of sealants in pancreatic surgery: A Systematic Review.Annals of medicine and surgery (2012) · 2021
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 1 country.

Christian M KühlbreyDepartment of Surgery, Faculty of Medicine, Clinic for Generalund Visceral Surgery, University of Freiburg Medical Center, Hugstetter Straße 55, D-79106 Freiburg, Germany.
Steivan KasperDepartment of Surgery, Faculty of Medicine, Clinic for Generalund Visceral Surgery, University of Freiburg Medical Center, Hugstetter Straße 55, D-79106 Freiburg, Germany.
Sophia ChikhladzeDepartment of Surgery, Faculty of Medicine, Clinic for Generalund Visceral Surgery, University of Freiburg Medical Center, Hugstetter Straße 55, D-79106 Freiburg, Germany.
Gabriel SeifertDepartment of Surgery, Faculty of Medicine, Clinic for Generalund Visceral Surgery, University of Freiburg Medical Center, Hugstetter Straße 55, D-79106 Freiburg, Germany.
Ulrich T HoptDepartment of Surgery, Faculty of Medicine, Clinic for Generalund Visceral Surgery, University of Freiburg Medical Center, Hugstetter Straße 55, D-79106 Freiburg, Germany.
Stefan Fichtner-FeiglDepartment of Surgery, Faculty of Medicine, Clinic for Generalund Visceral Surgery, University of Freiburg Medical Center, Hugstetter Straße 55, D-79106 Freiburg, Germany.
Uwe A WittelDepartment of Surgery, Faculty of Medicine, Clinic for Generalund Visceral Surgery, University of Freiburg Medical Center, Hugstetter Straße 55, D-79106 Freiburg, Germany.
University of Freiburg · DEUniversity Medical Center Freiburg · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundBio-absorbable sealants are widely used to reduce the rate and severity of postoperative pancreatic fistulas after distal pancreatectomy. However, numerous clinical trials have failed to demonstrate their clinical benefit. We therefore investigated stability and bio-compatibility of absorbable sealants in vitro and in vivo.

methodsIn vitro, polymerized compounds were incubated in pancreatic juice before their stability was tested. In vivo, two compounds were used to seal the pancreatic stump after distal pancreatectomy in nine pigs. Burst pressure of the pancreatic stump, surgical outcome, histology of the pancreatic stump, systemic inflammation, and drain fluid was examined.

resultsProducts based on fibrin or collagen were unstable in the presence of active pancreatic enzymes and completely dissolved within 2 h. Sealants using chemical cross-linking of proteins showed improved stability for 7 days. In vivo, application of polyethylenglycol-based sealant leads to complete closure of the pancreatic duct after 5 days, while a glutaraldehyde-based sealant prevented physiological closure of the pancreatic main duct.

conclusionsMany compounds used clinically to reinforce the pancreatic stump after distal pancreatectomy are inadequate due to instability in the presence of pancreatic enzymes. While selected bio-absorbable sealants inhibited the natural healing of the pancreatic stump, polyethylenglycol-based sealants should be tested in further clinical trials.

Indexed as

Absorbable ImplantsPancreatic JuiceAnimal DiseasesAnimalsFemaleHemostaticsHumansIn Vitro TechniquesPancreasPancreatectomyPancreatic FistulaPolyethylene GlycolsProsthesis FailureSwineTissue AdhesivesHemostaticsPolyethylene GlycolsTissue AdhesivesAdhesivesAnimal modelPancreasPancreatic fistulaPolyethylene glycols

Identifiers

PMID30589508
PMCPMC6593819
OpenAlexW2908276801

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.