Stapler sizes optimized for pancreatic thickness can reduce pancreatic fistula incidence after distal pancreatectomy View Full Text


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Article Info

DATE

2019-11-30

AUTHORS

Makoto Nishikawa, Junji Yamamoto, Mayumi Hoshikawa, Takahiro Einama, Takuji Noro, Suefumi Aosasa, Hironori Tsujimoto, Hideki Ueno, Yoji Kishi

ABSTRACT

PurposeThe purpose of this paper was to identify the optimum-sized stapler cartridges for reducing the incidence of postoperative pancreatic fistula (POPF) after distal pancreatectomy (DP).MethodsThe authors retrospectively analyzed 101 patients who underwent DP with a triple-row stapler to identify the clinicopathological factors that strongly influence POPF after DP. The height difference (HD) was defined as the difference between the pancreatic thickness and the height of the closed stapler.ResultsPOPF occurred in 58 (57%) patients. A multivariate analysis identified HD and pancreatic thickness as independent risk factors for the occurrence of POPF after DP. Akaike’s information criterion for identifying the risk factors was more favorable for HD (115.18) than for pancreatic thickness (118.02). The incidence of POPF was significantly lower (29%) in patients with an HD between 6 and 12 mm than in the other two groups (< 6-mm group: 100%, P = 0.008; ≥ 12-mm group: 84%, P < 0.001).ConclusionsA too-thick or too-narrow pancreas carries a risk of developing POPF after DP when using a triple-row stapler. Selecting staplers to achieve an HD of 6–12 mm may reduce the incidence of POPF following DP. More... »

PAGES

623-631

References to SciGraph publications

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  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s00595-019-01929-z

    DOI

    http://dx.doi.org/10.1007/s00595-019-01929-z

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1123041387

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/31786683


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    32 schema:description PurposeThe purpose of this paper was to identify the optimum-sized stapler cartridges for reducing the incidence of postoperative pancreatic fistula (POPF) after distal pancreatectomy (DP).MethodsThe authors retrospectively analyzed 101 patients who underwent DP with a triple-row stapler to identify the clinicopathological factors that strongly influence POPF after DP. The height difference (HD) was defined as the difference between the pancreatic thickness and the height of the closed stapler.ResultsPOPF occurred in 58 (57%) patients. A multivariate analysis identified HD and pancreatic thickness as independent risk factors for the occurrence of POPF after DP. Akaike’s information criterion for identifying the risk factors was more favorable for HD (115.18) than for pancreatic thickness (118.02). The incidence of POPF was significantly lower (29%) in patients with an HD between 6 and 12 mm than in the other two groups (< 6-mm group: 100%, P = 0.008; ≥ 12-mm group: 84%, P < 0.001).ConclusionsA too-thick or too-narrow pancreas carries a risk of developing POPF after DP when using a triple-row stapler. Selecting staplers to achieve an HD of 6–12 mm may reduce the incidence of POPF following DP.
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