title: Management of remnant pancreatic stump fto prevent the development of postoperative pancreatic fistulas after distal pancreatectomy: current evidence and our strategy.
abstract: Distal pancreatectomy (DP) is the most common surgical procedure for treating benign and malignant lesions in the body or tail of the pancreas. Although the mortality rate related to DP has recently been reduced, the postoperative morbidity remains high. The most frequent and dismal complication occurring after DP is the development of postoperative pancreatic fistulas (POPF). Several resection methods and closure techniques for treating remnant pancreas have been developed in an effort to reduce the incidence of complications, especially POPF. However, the optimal procedure has not yet been established. In this review, we summarize the current clinical data and evidence for surgical techniques and perioperative management strategies for preventing POPF after DP. Finally, we introduce our non-closure technique for managing remnant pancreatic stumps.
authors.affiliation: Department of Gastroenterologic Surgery, Graduate School of Medical Science, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa 920-8641, Japan. i.makino@staff.kanazawa-u.ac.jp
authors.forename: Isamu
authors.initials: I
authors.lastname: Makino
authors.forename: Hirohisa
authors.initials: H
authors.lastname: Kitagawa
authors.forename: Hisatoshi
authors.initials: H
authors.lastname: Nakagawara
authors.forename: Hidehiro
authors.initials: H
authors.lastname: Tajima
authors.forename: Itasu
authors.initials: I
authors.lastname: Ninomiya
authors.forename: Sachio
authors.initials: S
authors.lastname: Fushida
authors.forename: Takashi
authors.initials: T
authors.lastname: Fujimura
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Ohta
mesh_terms: D019317:Evidence-Based Medicine; D006801:Humans; D015994:Incidence; D010179:Pancreas / Q000601:surgery*; D010180:Pancreatectomy / Q000379:methods* / Q000706:statistics & numerical data; D010185:Pancreatic Fistula / Q000453:epidemiology / Q000517:prevention & control*; D019990:Perioperative Care; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control*; D013536:Suture Techniques