Ann Hepatobiliary Pancreat Surg.  2016 Nov;20(4):191-196. 10.14701/ahbps.2016.20.4.191.

Effect of polylactic film (Surgi-Wrap) on preventing postoperative ileus after major hepato-pancreato-biliary surgery

• Lee CH
• Kim H
• Han IW
• Kim SM
• Kwak BS
• Baik YH
• Park YJ
• Oh MG

• KMID: 2362470
• DOI: http://doi.org/10.14701/ahbps.2016.20.4.191

Abstract

BACKGROUNDS/AIMS
Major hepato-pancreato-biliary (HPB) surgery is usually performed via an open method rather than a laparoscopic method. Postoperative ileus (POI) is a classic complication after open surgery. The purpose of this study was to determine whether polylactic film is useful in the prevention of POI.
METHODS
A total of 179 patients who underwent major HPB surgery between 2005 and 2014, were retrospectively reviewed. A diagnosis of POI was made by a physical examination, laboratory, and radiological findings. Surgi-Wrap® polylactic film was preferentially used intraperitoneally by surgeons, just before wound closure.
RESULTS
Major HPB surgery included pancreatoduodenectomy (n=48), distal or subtotal pancreatectomy (n=24), hepatectomy (n=67), other bile duct or gallbladder operations (n=35), and others (n=5). Although patients with polylactic film showed a significantly lower incidence of POI (n=3, 4.1% vs. n=14, 13.3%, p=0.041), they showed a significantly higher complication rate (n=20, 27.0% vs. n=19, 18.1%, p=0.004), particularly intra-abdominal fluid collection (n=7, 9.4% vs. n=2, 1.9%), and wound infections (n=6, 8.1% vs. n=3, 2.9%), than those who did not receive the film, respectively.
CONCLUSIONS
Although the polylactic film prevented POI, more complications other than POI were observed. Well-designed randomized controlled trials, using this anti-adhesive product, are needed to evaluate its effect on POI after major HPB surgery.

Keyword

Polylactic film; Postoperative ileus

MeSH Terms

Bile Ducts
Diagnosis
Gallbladder
Hepatectomy
Humans
Ileus*
Incidence
Methods
Pancreatectomy
Pancreaticoduodenectomy
Physical Examination
Retrospective Studies
Surgeons
Wound Infection
Wounds and Injuries

Figure

• 

  Fig. 1 Incidence rate of POI. The patients without Surgi-Wrap® had a significantly higher POI rate than those with Surgi-Wrap® (n=14, 13.3% vs. n=3, 4.1%; p=0.041).

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