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A Thick Pancreas Is a Risk Factor for Pancreatic Fistula after a Distal Pancreatectomy: Selection of the Closure Technique according to the Thickness.
MedLine Citation:
PMID:  21293132     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background/Aims: Hand-sewn closures or stapler closures of the pancreatic remnant after a distal pancreatectomy have commonly been employed; however, the choice of technique in each patient depending on their clinical characteristics has not been discussed. Methods: Forty-eight patients who underwent a distal pancreatectomy at Osaka University Hospital between January 2007 and October 2009 were enrolled. A hand-sewn closure was planned during the 1st period (before June 2008, 26 consecutive patients), whereas a stapler closure was planned for the 2nd period (after June 2008, 22 consecutive patients). The incidence of pancreatic fistula and the patients' characteristics were retrospectively investigated. Results: Seven patients (27%) developed a fistula in the hand-sewn group, while 5 (23%) developed a fistula in the stapler group (p = n.s.). Using logistic regression analysis for all patients, younger age and the thickness of the pancreatic remnant were identified as independent risk factors for pancreatic fistula. In the stapler group, 50% of patients with a thick pancreas developed a pancreatic fistula, while no patients with a thin pancreas developed one. Conclusion: Thick pancreas is one of the risk factors for pancreatic fistula after a distal pancreatectomy; however, a stapler closure seems to be suitable at least for thin pancreas.
Authors:
Hidetoshi Eguchi; Hiroaki Nagano; Masahiro Tanemura; Yutaka Takeda; Shigeru Marubashi; Shogo Kobayashi; Hiroshi Wada; Koji Umeshita; Masaki Mori; Yuichiro Doki
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-2-04
Journal Detail:
Title:  Digestive surgery     Volume:  28     ISSN:  1421-9883     ISO Abbreviation:  -     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-2-4     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8501808     Medline TA:  Dig Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  50-56     Citation Subset:  -    
Copyright Information:
Copyright © 2011 S. Karger AG, Basel.
Affiliation:
Department of Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan.
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