ArticleLangenbeck's archives of surgery2026
TachoSil
Article in Langenbeck's archives of surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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7 authors.
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Abstract
purposePostpancreatectomy hemorrhage (PPH) is a rare but potentially lethal complication after distal pancreatectomy (DP), often precipitated by clinically relevant postoperative pancreatic fistula (POPF). While the fibrin sealant patch TachoSil® has been evaluated for POPF prevention, its role in mitigating PPH remains underexplored.
methodsWe conducted a single-center, retrospective cohort study of consecutive adult patients undergoing DP (2015–2024). Patients were classified by intraoperative use of TachoSil® in addition to standard stump closure. The primary endpoint was PPH, defined per International Study Group of Pancreatic Surgery (ISGPS) criteria. Secondary endpoints included clinically relevant POPF, Comprehensive Complication Index (CCI), reoperation, 90-day mortality, and length of stay (LOS). Inverse probability of treatment weighting (IPTW) was applied to adjust for baseline covariates.
resultsOf 224 patients, 56 (25%) received TachoSil®. After IPTW adjustment, TachoSil® was associated with a reduced risk of PPH (RD − 0.065; 95% CI − 0.121 to − 0.009; p = 0.014), corresponding to a number needed to treat (NNT) of 15 and an E-value of 6.7. No significant differences were observed for clinically relevant POPF (RD 0.116; p = 0.105), CCI (MD 3.459; p = 0.091), reoperation (RD − 0.016; p = 0.486), 90-day mortality (RD 0.012; p = 0.498), or LOS (MD − 0.242 days; p = 0.856). Stratified analysis showed a pronounced reduction in PPH among patients who developed POPF (RD − 0.180; 95% CI − 0.311 to − 0.048; p = 0.004; NNT = 6; E-value = 12.6), while no significant effect was observed in patients without POPF.
conclusionsTachoSil® use after DP was not associated with lower POPF rates but significantly reduced PPH incidence, particularly in patients developing POPF. These findings support selective TachoSil® application in high-risk patients as part of a targeted strategy to prevent severe hemorrhagic complications after DP.
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