Risk factor analysis and prevention of postoperative pancreatic fistula after distal pancreatectomy with stapler use View Full Text


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Article Info

DATE

2013-02-22

AUTHORS

Motokazu Sugimoto, Naoto Gotohda, Yuichiro Kato, Shinichiro Takahashi, Takahiro Kinoshita, Hidehito Shibasaki, Shogo Nomura, Masaru Konishi, Hironori Kaneko

ABSTRACT

BackgroundPostoperative pancreatic fistula (POPF) is a major, intractable complication after distal pancreatectomy (DP). Risk factor evaluation and prevention of this complication are important tasks for pancreatic surgeons.MethodsOne hundred and six patients who underwent DP using a stapler for pancreatic division were retrospectively investigated. The relationship between clinicopathological factors and the incidence of POPF was statistically analyzed.ResultsClinically relevant, Grade B or C POPF by International Study Group of Pancreatic Fistula criteria occurred in 52 patients (49.1 %). Age, American Society of Anesthesiologists score, body mass index, and concomitant gastrointestinal tract resection did not influence the incidence of POPF. Use of a double-row stapler and a thick pancreatic stump were significant risk factors for POPF in multivariate analysis. Compression index was also shown to be an important factor in cases in which the pancreas was divided by a stapler.ConclusionsThe most important risk factor for POPF after DP was suggested to be the thickness of the pancreatic stump, reflecting the volume of remnant pancreas. A triple-row stapler seemed to be superior to a double-row stapler in preventing POPF. However, triple-row stapler use in a thick pancreas is considered to be a future problem to be solved. More... »

PAGES

538-544

References to SciGraph publications

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  • 2010-08-21. Prolonged peri-firing compression with a linear stapler prevents pancreatic fistula in laparoscopic distal pancreatectomy in SURGICAL ENDOSCOPY
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  • 2008-07. Nonclosure technique with saline-coupled bipolar electrocautery in management of the cut surface after distal pancreatectomy in JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES
  • 2012-03-06. After Distal Pancreatectomy Pancreatic Leakage from the Stump of the Pancreas May Be Due to Drain Failure or Pancreatic Ductal Back Pressure in JOURNAL OF GASTROINTESTINAL SURGERY
  • 2011-10-21. The Influence of Staple Size on Fistula Formation Following Distal Pancreatectomy in JOURNAL OF GASTROINTESTINAL SURGERY
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    29 schema:description BackgroundPostoperative pancreatic fistula (POPF) is a major, intractable complication after distal pancreatectomy (DP). Risk factor evaluation and prevention of this complication are important tasks for pancreatic surgeons.MethodsOne hundred and six patients who underwent DP using a stapler for pancreatic division were retrospectively investigated. The relationship between clinicopathological factors and the incidence of POPF was statistically analyzed.ResultsClinically relevant, Grade B or C POPF by International Study Group of Pancreatic Fistula criteria occurred in 52 patients (49.1 %). Age, American Society of Anesthesiologists score, body mass index, and concomitant gastrointestinal tract resection did not influence the incidence of POPF. Use of a double-row stapler and a thick pancreatic stump were significant risk factors for POPF in multivariate analysis. Compression index was also shown to be an important factor in cases in which the pancreas was divided by a stapler.ConclusionsThe most important risk factor for POPF after DP was suggested to be the thickness of the pancreatic stump, reflecting the volume of remnant pancreas. A triple-row stapler seemed to be superior to a double-row stapler in preventing POPF. However, triple-row stapler use in a thick pancreas is considered to be a future problem to be solved.
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    36 schema:keywords American Society
    37 BackgroundPostoperative pancreatic fistula
    38 C POPF
    39 International Study Group
    40 MethodsOne hundred
    41 POPF
    42 Pancreatic Fistula criteria
    43 ResultsClinically
    44 age
    45 analysis
    46 anesthesiologists
    47 body mass index
    48 cases
    49 clinicopathological factors
    50 complications
    51 compression index
    52 criteria
    53 distal pancreatectomy
    54 division
    55 evaluation
    56 factor analysis
    57 factor evaluation
    58 factors
    59 fistula
    60 future problems
    61 gastrointestinal tract resection
    62 grade B
    63 group
    64 hundreds
    65 important factor
    66 important risk factor
    67 important task
    68 incidence
    69 incidence of POPF
    70 index
    71 intractable complication
    72 mass index
    73 multivariate analysis
    74 pancreas
    75 pancreatectomy
    76 pancreatic division
    77 pancreatic fistula
    78 pancreatic stump
    79 pancreatic surgeons
    80 patients
    81 postoperative pancreatic fistula
    82 prevention
    83 problem
    84 relationship
    85 remnant pancreas
    86 resection
    87 risk factor analysis
    88 risk factor evaluation
    89 risk factors
    90 significant risk factors
    91 society
    92 stapler
    93 stapler use
    94 study group
    95 stump
    96 surgeons
    97 task
    98 thick pancreas
    99 thickness
    100 triple-row stapler
    101 use
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    103 schema:name Risk factor analysis and prevention of postoperative pancreatic fistula after distal pancreatectomy with stapler use
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