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Does Pancreatic Stump Closure Method Influence Distal Pancreatectomy Outcomes?

Authors :
Ceppa EP
McCurdy RM
Becerra DC
Kilbane EM
Zyromski NJ
Nakeeb A
Schmidt CM
Lillemoe KD
Pitt HA
House MG
Source :
Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract [J Gastrointest Surg] 2015 Aug; Vol. 19 (8), pp. 1449-56. Date of Electronic Publication: 2015 Apr 23.
Publication Year :
2015

Abstract

Background: Pancreatic fistula remains the primary source of morbidity following distal pancreatectomy. Previous studies have reported specific methods of parenchymal transection/stump sealing in an effort to decrease the pancreatic fistula rate with highly variable results. The aim of this study was to determine postoperative outcomes following various pancreatic stump-sealing methods.<br />Study Design: All cases of distal pancreatectomy were reviewed at a single institution between January 2008 and June 2011 and were monitored with complete 30-day outcomes through ACS-NSQIP. Pancreatic stump-sealing method was used to create three operation groups (suture, staple, or saline-linked radiofrequency). Two- and three-way statistical analyses were performed among the operation groups.<br />Results: Two hundred three patients underwent distal pancreatectomy. The most common diagnoses included chronic pancreatitis, adenocarcinoma, and IPMN. The suture, staple, and SLRF groups included 90 (44%), 61 (30%), and 52 (26%) patients, respectively. Overall complications (range 31-38%) and pancreatic fistula (range 25-26%) were similar with each pancreatic closure technique. Operative technique was not associated with an increased need for postoperative interventions or hospital readmission.<br />Conclusions: Postoperative outcomes after distal pancreatectomy are unaffected by the use of SLRF sealing of the pancreatic stump when compared to traditional suture or reinforced stapling techniques.

Details

Language :
English
ISSN :
1873-4626
Volume :
19
Issue :
8
Database :
MEDLINE
Journal :
Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
Publication Type :
Academic Journal
Accession number :
25903852
Full Text :
https://doi.org/10.1007/s11605-015-2825-0