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Journal of Hepato-Biliary-Pancreatic Sciences

Published in:

01-06-2013 | Original article

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

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

Published in: Journal of Hepato-Biliary-Pancreatic Sciences | Issue 5/2013

Abstract

Background

Postoperative 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.

Methods

One 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.

Results

Clinically 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.

Conclusions

The 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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Title: Risk factor analysis and prevention of postoperative pancreatic fistula after distal pancreatectomy with stapler use
Authors: Motokazu Sugimoto
Naoto Gotohda
Yuichiro Kato
Shinichiro Takahashi
Takahiro Kinoshita
Hidehito Shibasaki
Shogo Nomura
Masaru Konishi
Hironori Kaneko
Publication date: 01-06-2013
Publisher: Springer Japan
Published in: Journal of Hepato-Biliary-Pancreatic Sciences / Issue 5/2013
Print ISSN: 1868-6974
Electronic ISSN: 1868-6982
DOI: https://doi.org/10.1007/s00534-013-0596-0

At a glance: The STEP trials

Springer Medicine

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

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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