PATCH-DP: a single-arm phase II trial of intra-operative application of HEMOPATCH™ to the pancreatic stump to prevent post-operative pancreatic fistula following distal pancreatectomy Academic Article uri icon

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abstract

  • BACKGROUND: Post-operative pancreatic fistula (POPF) is the most significant cause of morbidity following distal pancreatectomy. Hemopatch™ is a thin, bovine collagen-based hemostatic sealant. We hypothesized that application of Hemopatch™ to the pancreatic stump following distal pancreatectomy would decrease the incidence of clinically-significant POPF. METHODS: We conducted a prospective, single-arm, multicentre phase II study of application of Hemopatch™ to the pancreatic stump following distal pancreatectomy. The primary outcome was clinically-significant POPF within 90 days of surgery. A sample size of 52 patients was required to demonstrate a 50% relative reduction in Grade B/C POPF from a baseline incidence of 20%, with a type I error of 0.2 and power of 0.75. Secondary outcomes included incidence of POPF (all grades), 90-day mortality, 90-day morbidity, re-interventions, and length of stay. RESULTS: Adequate fixation Hemopatch™ to the pancreatic stump was successful in all cases. The rate of grade B/C POPF was 25% (95%CI: 14.0-39.0%). There was no significant difference in the incidence of grade B/C POPF compared to the historical baseline (p = 0.46). The 90-day incidence of Clavien-Dindo grade ≥3 complications was 26.9% (95%CI: 15.6-41.0%). CONCLUSION: The use of Hemopatch™ was not associated with a decreased incidence of clinically-significant POPF compared to historical rates. (NCT03410914).

authors

  • Serrano Aybar, Pablo
  • Bubis, Lev D
  • Behman, Ramy
  • Roke, Rachel
  • Serrano, Pablo E
  • Khalil, Jad A
  • Coburn, Natalie G
  • Law, Calvin H
  • Bertens, Kimberly
  • Martel, Guillaume
  • Hallet, Julie
  • Marcaccio, Michael Joseph
  • Balaa, Fady
  • Quan, Douglas
  • Gallinger, Steven
  • Nanji, Sulaiman
  • Leslie, Ken
  • Tandan, Ved
  • Luo, Yigang
  • Beck, Gavin
  • Skaro, Anton
  • Dath, Deepak
  • Moser, Michael
  • Karanicolas, Paul J

publication date

  • June 2021

published in

  • HPB  Journal