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- Title
Simplicity and Safety: Minimized Pancreatic Fistula Rate after Distal Pancreatectomy through Pancreas Stump Sutured Fish-Mouth Closure.
- Authors
MINARICH, MICHAEL J.; SCHWARZ, RODERICH E.
- Abstract
Pancreatic stump leak after distal pancreatectomy (DP) is a major determinant for impaired postoperative recovery. Factors influencing pancreatic fistula (PF) occurrence remain of interest. Prospectively collected data from an academic surgical oncology practice were examined for predictors of PF. Seventy-five of 294 pancreatectomy patients underwent DP (26%). There were 33 men and 42 women, with a median age of 61 years (range: 18-85 years). Underlying conditions included cancer (60%) and benign processes (40%). Resections were comprising open DP (64%), laparoscopic DP (21%), and open multivisceral resections (15%). Of 21 cases with postoperative complications (28%, no death), six were PFs (8%, 2 grade A and 4 grade B). The median length of stay was six days (4-24). The PF rate was 2.0 per cent in 50 patients after sutured fish-mouth closures, but 20 per cent in cases using other techniques including stapling (P = 0.007); no other variable was linked to PF occurrence. Length of stay was linked to complications, resection extent, malignancy, and transfusions (all at P < 0.02), but not to PF. PF rate after DP in this experience is unaffected by splenic vessel resection but seems to be minimized through a sutured fish-mouth closure technique.
- Subjects
UNITED States; PANCREATIC fistula; PANCREATECTOMY; CANCER treatment; SURGICAL complications; ELECTROCOAGULATION (Medicine); PANCREATIC surgery; PREVENTION of surgical complications; ABDOMINAL surgery; COMPARATIVE studies; DATABASES; LAPAROSCOPY; LONGITUDINAL method; RESEARCH methodology; MEDICAL cooperation; MULTIVARIATE analysis; NONPARAMETRIC statistics; PANCREAS; PANCREATIC tumors; PATIENT safety; PROGNOSIS; RESEARCH; RISK assessment; SUTURES; SUTURING; LOGISTIC regression analysis; EVALUATION research; TREATMENT effectiveness; RETROSPECTIVE studies
- Publication
American Surgeon, 2018, Vol 84, Issue 11, p1734
- ISSN
0003-1348
- Publication type
journal article
- DOI
10.1177/000313481808401127