Prolonged peri-firing compression with a linear stapler prevents pancreatic fistula in laparoscopic distal pancreatectomy.
BACKGROUND
Laparoscopic distal pancreatectomy (Lap-DP) is one of the most accepted laparoscopic procedures in the field of pancreatic surgery. However, pancreatic fistula remains a major and frequent complication in Lap-DP, as in open surgery. The aim of this retrospective study is to clarify the advantages of prolonged peri-firing compression (PFC) with a linear stapler for prevention of pancreatic fistula after laparoscopic distal pancreatectomy.


METHODS
Incidence of pancreatic fistula in clinical levels (equivalent to grades B and C defined by the International Study Group of Pancreatic Fistula (ISGPF)) was retrospectively compared between patients who underwent Lap-DP with PFC (PFC group, n = 17) and those who underwent Lap-DP without PFC (no-PFC group, n = 25).


RESULTS
Incidence of clinical pancreatic fistula was significantly lower in the PFC group than in the no-PFC group. Consistent with the results for pancreatic fistula, peritoneal drainage period and postoperative hospital stay were shorter in the PFC group than in the no-PFC group.


CONCLUSIONS
Our data show that PFC effectively prevents pancreatic fistula and shortens postoperative hospital stay after Lap-DP.
Nakamura
Masafumi
M
Department of Surgery and Oncology, Kyushu University, Fukuoka, Japan. mnaka@surg1.med.kyushu-u.ac.jp
Ueda
Junji
J
Kohno
Hiroshi
H
Aly
Mohamed Yahia F
MY
Takahata
Shunichi
S
Shimizu
Shuji
S
Tanaka
Masao
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000681:Amylases / Q000097:blood; D004867:Equipment Design; D005260:Female; D006801:Humans; D015994:Incidence; D010535:Laparoscopy / Q000379:methods*; D007813:Laparotomy; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy / Q000379:methods*; D010185:Pancreatic Fistula / Q000453:epidemiology / Q000517:prevention & control*; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control*; D011312:Pressure; D012189:Retrospective Studies; D013396:Suction; D013528:Surgical Staplers; D017792:Surgical Stapling / Q000379:methods*; D055815:Young Adult
D000681:Amylases