Obsidian ASG autologous platelet-rich fibrin matrix for the prevention of postoperative pancreatic fistula following pancreatic resection: study protocol for a feasibility trial at the Medical University of Vienna

Introduction Postoperative pancreatic fistula (POPF) is the most frequent complication after partial pancreatectomy, which is by definition associated with clinical consequences requiring changes in postoperative management. Despite numerous scientific efforts, effective procedures to prevent POPF a...

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Main Authors: Ulla Klaiber, Oliver Strobel, Martin Schindl, Charlotte Gustorff, Christopher Dawoud, Carl-Stephan Leonhardt, Stefan Riss, Klaus Sahora
Format: Article
Language:English
Published: BMJ Publishing Group 2025-03-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/15/3/e088867.full
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author Ulla Klaiber
Oliver Strobel
Martin Schindl
Charlotte Gustorff
Christopher Dawoud
Carl-Stephan Leonhardt
Stefan Riss
Klaus Sahora
author_facet Ulla Klaiber
Oliver Strobel
Martin Schindl
Charlotte Gustorff
Christopher Dawoud
Carl-Stephan Leonhardt
Stefan Riss
Klaus Sahora
author_sort Ulla Klaiber
collection DOAJ
description Introduction Postoperative pancreatic fistula (POPF) is the most frequent complication after partial pancreatectomy, which is by definition associated with clinical consequences requiring changes in postoperative management. Despite numerous scientific efforts, effective procedures to prevent POPF are lacking. Obsidian ASG autologous platelet-rich fibrin matrix has been effectively applied to prevent anastomotic leakage following colorectal surgery. This study is the first to investigate the feasibility of using the sealant in pancreatic surgery.Methods and analysis 25 consecutive patients scheduled for elective formal partial pancreatectomy due to any underlying disease fulfilling the eligibility criteria will be included. Obsidian ASG sealant prepared out of 120 mL of each patient’s whole blood will be applied to the pancreatic stump or the pancreatic anastomosis, respectively. The primary endpoint is the feasibility of the procedure, for example, the proportion of patients undergoing successful trial intervention. Secondary endpoints comprise safety and surgical outcome parameters including rate and severity of POPF as well as further pancreas-specific complications as defined by the International Study Group of Pancreatic Surgery during 90 days after surgery. Patients will be matched with a historic collective in a 1:2 ratio to gain first data on efficacy.Ethics and dissemination This trial and the associated study protocol (V.1.1.1, date 26 March 2024) were approved by the institution’s ethics committee (reference number 2191/2023). All trial procedures are performed in accordance with the International Council for Harmonisation harmonised tripartite guideline on Good Clinical Practice and the ethical principles of the Declaration of Helsinki. After completion of the study, results will be published in due course.Trial registration number The trial was registered in the German Clinical Trials Register on 6 May 2024 (DRKS-ID: DRKS00034052).
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spelling doaj-art-9bd57bfcdff040e693752cef6f02ff632025-08-20T03:42:04ZengBMJ Publishing GroupBMJ Open2044-60552025-03-0115310.1136/bmjopen-2024-088867Obsidian ASG autologous platelet-rich fibrin matrix for the prevention of postoperative pancreatic fistula following pancreatic resection: study protocol for a feasibility trial at the Medical University of ViennaUlla Klaiber0Oliver Strobel1Martin Schindl2Charlotte Gustorff3Christopher Dawoud4Carl-Stephan Leonhardt5Stefan Riss6Klaus Sahora7Department of General Surgery, Medical University of Vienna, Wien, AustriaDepartment of General, Visceral, and Transplantation Surgery, University of Heidelberg, Heidelberg, GermanyComprehensive Cancer Center, Medical University Vienna, Wien, AustriaDepartment of General Surgery, Division of Visceral Surgery, Medical University of Vienna, Vienna, AustriaDepartment of General Surgery, Division of Visceral Surgery, Medical University of Vienna, Vienna, AustriaDepartment of General Surgery, Division of Visceral Surgery, Medical University of Vienna, Vienna, AustriaDepartment of General Surgery, Division of Visceral Surgery, Medical University of Vienna, Vienna, AustriaDepartment of General Surgery, Division of Visceral Surgery, Medical University of Vienna, Vienna, AustriaIntroduction Postoperative pancreatic fistula (POPF) is the most frequent complication after partial pancreatectomy, which is by definition associated with clinical consequences requiring changes in postoperative management. Despite numerous scientific efforts, effective procedures to prevent POPF are lacking. Obsidian ASG autologous platelet-rich fibrin matrix has been effectively applied to prevent anastomotic leakage following colorectal surgery. This study is the first to investigate the feasibility of using the sealant in pancreatic surgery.Methods and analysis 25 consecutive patients scheduled for elective formal partial pancreatectomy due to any underlying disease fulfilling the eligibility criteria will be included. Obsidian ASG sealant prepared out of 120 mL of each patient’s whole blood will be applied to the pancreatic stump or the pancreatic anastomosis, respectively. The primary endpoint is the feasibility of the procedure, for example, the proportion of patients undergoing successful trial intervention. Secondary endpoints comprise safety and surgical outcome parameters including rate and severity of POPF as well as further pancreas-specific complications as defined by the International Study Group of Pancreatic Surgery during 90 days after surgery. Patients will be matched with a historic collective in a 1:2 ratio to gain first data on efficacy.Ethics and dissemination This trial and the associated study protocol (V.1.1.1, date 26 March 2024) were approved by the institution’s ethics committee (reference number 2191/2023). All trial procedures are performed in accordance with the International Council for Harmonisation harmonised tripartite guideline on Good Clinical Practice and the ethical principles of the Declaration of Helsinki. After completion of the study, results will be published in due course.Trial registration number The trial was registered in the German Clinical Trials Register on 6 May 2024 (DRKS-ID: DRKS00034052).https://bmjopen.bmj.com/content/15/3/e088867.full
spellingShingle Ulla Klaiber
Oliver Strobel
Martin Schindl
Charlotte Gustorff
Christopher Dawoud
Carl-Stephan Leonhardt
Stefan Riss
Klaus Sahora
Obsidian ASG autologous platelet-rich fibrin matrix for the prevention of postoperative pancreatic fistula following pancreatic resection: study protocol for a feasibility trial at the Medical University of Vienna
BMJ Open
title Obsidian ASG autologous platelet-rich fibrin matrix for the prevention of postoperative pancreatic fistula following pancreatic resection: study protocol for a feasibility trial at the Medical University of Vienna
title_full Obsidian ASG autologous platelet-rich fibrin matrix for the prevention of postoperative pancreatic fistula following pancreatic resection: study protocol for a feasibility trial at the Medical University of Vienna
title_fullStr Obsidian ASG autologous platelet-rich fibrin matrix for the prevention of postoperative pancreatic fistula following pancreatic resection: study protocol for a feasibility trial at the Medical University of Vienna
title_full_unstemmed Obsidian ASG autologous platelet-rich fibrin matrix for the prevention of postoperative pancreatic fistula following pancreatic resection: study protocol for a feasibility trial at the Medical University of Vienna
title_short Obsidian ASG autologous platelet-rich fibrin matrix for the prevention of postoperative pancreatic fistula following pancreatic resection: study protocol for a feasibility trial at the Medical University of Vienna
title_sort obsidian asg autologous platelet rich fibrin matrix for the prevention of postoperative pancreatic fistula following pancreatic resection study protocol for a feasibility trial at the medical university of vienna
url https://bmjopen.bmj.com/content/15/3/e088867.full
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