Gastric wall-covering method prevents pancreatic fistula after distal pancreatectomy.
OBJECTIVE
Pancreatic fistula is the most common complication after distal pancreatectomy. The aim of this study was to evaluate retrospectively the usefulness of a new surgical technique, the gastric wall-covering method, after distal pancreatectomy.


METHODS
The study group consisted of 53 patients who underwent distal pancreatectomy. The management of the stump of the remnant pancreas was accomplished by the gastric wall-covering method (GWC group, n=20) or by conventional surgery (CS group, n=33). In the gastric wall-covering method, the cut surface of the pancreas is fixed to the posterior wall of the gastric body.


RESULTS
There were no significant differences in operating time, intraoperative blood loss, or texture of the remnant stump between the two groups. Postoperative pancreatic fistula was diagnosed in 1 patient (5.0%) in the GWC group and in 12 patients (36.4%) in the CS group (P=0.01).


CONCLUSIONS
The gastric wall-covering method for the management of the pancreatic stump after distal pancreatectomy reduces the incidence of postoperative pancreatic fistula.
Kuroki
Tamotsu
T
Department of Surgery, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan. tkuroki-gi@umin.ac.jp
Tajima
Yoshitsugu
Y
Tsuneoka
Noritsugu
N
Adachi
Tomohiko
T
Kanematsu
Takashi
T
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy / Q000009:adverse effects*; D010185:Pancreatic Fistula / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control*; D012189:Retrospective Studies; D012307:Risk Factors; D013270:Stomach / Q000601:surgery*; D013536:Suture Techniques; D055815:Young Adult