Postoperative pancreatic fistula in distal pancreatectomy: experience from 1 institution.
OBJECTIVE
Postoperative pancreatic fistula (POPF) and readmission remain the significant sources of morbidity after distal pancreatectomy (DP). We describe a technique of drainage and postoperation management to prevent severe POPF and readmission.


METHODS
A retrospective analysis of 57 patients who underwent DP from January 2009 to November 2011 was conducted. The drain was placed just abutting the pancreatic stump by suturing the tissue near the stump. Each patient was discharged carrying an intraabdominal drain, and a strict follow-up was made in the outpatient clinic. Postoperative pancreatic fistula was defined using the international study group classification for pancreatic fistula definition.


RESULTS
Thirty-two patients accepted laparoscopic DP (LDP), and 25 patients accepted open DP (ODP). There was no significant difference in the rate of POPF between the 2 groups (12/32 vs 11/25, P = 0.786). All the POPF cases were grades A and B, but no case was grade C. No case needed a specific intervention. There was no reoperation, readmission, intraabdominal abscess, or surgical site infection.


CONCLUSIONS
We conclude that our technique of drainage and postoperation management is associated with a low incidence of severe POPF and readmission. Continued investigation of this technique is warranted.
From the Department of General Surgery, Peking University Third Hospital, Haidian District, Beijing, People's Republic of China.
Hangyan
H
Wang
Dianrong
D
Xiu
Bin
B
Jiang
Chaolai
C
Ma
Chunhui
C
Yuan
D000328:Adult; D000368:Aged; D002681:China; D004322:Drainage / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy / Q000009:adverse effects* / Q000379:methods; D010185:Pancreatic Fistula / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D010359:Patient Readmission; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013536:Suture Techniques; D016896:Treatment Outcome; D055815:Young Adult