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01-12-2024 | Pancreaticojejunostomy | Research

Efficacy of pancreaticojejunostomy of the pancreatic stump during distal or central pancreatectomy

Authors: Teijiro Hirashita, Atsuro Fujinaga, Yuiko Nagasawa, Hiroki Orimoto, Shota Amano, Masahiro Kawamura, Takahide Kawasaki, Yoko Kawano, Takashi Masuda, Yuichi Endo, Masafumi Inomata

Published in: Langenbeck's Archives of Surgery | Issue 1/2024

Abstract

Background

A stapler is usually used for transection and closure of the pancreas in distal pancreatectomy (DP) or central pancreatectomy (CP). When the pancreas is transected to the right of the portal vein, it is difficult to use a stapler and clinically relevant postoperative pancreatic fistula (CR-POPF) frequently occurs. We report on the efficacy of pancreaticojejunostomy (PJ) of the pancreatic stump for patients in whom stapler use is difficult.

Methods

Patients who underwent DP or CP were enrolled in this study. The pancreas was usually transected by a stapler, and ultrasonic coagulating shears (UCS) were used depending on the tumor situation. When using UCS, hand-sewn closure or PJ was performed for the pancreatic stump. The relationship between clinicopathological factors and the methods of pancreatic transection and closure were investigated.

Results

In total, 164 patients underwent DP or CP, and the pancreas was transected with a stapler in 150 patients and UCS in 14 patients. The rate of CR-POPF was higher and the postoperative hospital stay was longer in the UCS group than in the stapler group. PJ of the pancreatic stump, which was performed for 7 patients, did not worsen intraoperative factors. CR-POPF was not seen in these 7 patients, which was significantly less than that with hand-sewn closure.

Conclusions

PJ of the pancreatic stump during DP or CP reduces CR-POPF compared with hand-sewn closure and may be useful especially when the pancreas is transected to the right of the portal vein.

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Title: Efficacy of pancreaticojejunostomy of the pancreatic stump during distal or central pancreatectomy
Authors: Teijiro Hirashita
Atsuro Fujinaga
Yuiko Nagasawa
Hiroki Orimoto
Shota Amano
Masahiro Kawamura
Takahide Kawasaki
Yoko Kawano
Takashi Masuda
Yuichi Endo
Masafumi Inomata
Publication date: 01-12-2024
Publisher: Springer Berlin Heidelberg
Keywords: Pancreaticojejunostomy
Pancreatectomy
Published in: Langenbeck's Archives of Surgery / Issue 1/2024
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-024-03335-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Efficacy of pancreaticojejunostomy of the pancreatic stump during distal or central pancreatectomy

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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