title: Complication analysis of distal pancreatectomy based on early personal experience.
abstract: OBJECTIVE
  The objective of this study was to evaluate the relationship between initial personal experiences with distal pancreatectomy and perioperative risk factors, outcomes, and management of pancreatic fistulas.
  
  
  METHODS
  Between May, 2007 and May, 2010, a total of 28 patients who had undergone elective distal pancreatectomy were evaluated for this study. Perioperative factors and the occurrence of pancreatic fistula were analyzed on the basis of International Study Group of Pancreatic Fistula (ISGPF) criteria.
  
  
  RESULTS
  There were sixteen cases of benign neoplasms and twelve cases of malignant tumors. The remnant pancreas was manually sutured with ligation of the pancreatic duct (n=14), auto-suture stapling along with manual sutures (n=12), or stapling alone (n=2). According to the ISGPF classification, morbidity and mortality associated with pancreatic fistulas was 42.9% (n=12) and 0%, respectively. These pancreatic fistulae were classified as grade A in 8 cases (28.6%), grade B in 3 cases (10.7%), and grade C in one case (3.6%). All patients with pancreatic fistula were treated conservatively.
  
  
  CONCLUSIONS
  Perioperative factors do not affect the risk of pancreatic fistula. Adequate drainage is the most effective method for management of a pancreatic fistula after distal pancreatectomy.
authors.affiliation: Department of Surgery, Postgraduate School of Medicine, Pusan National University, Busan, Korea.
authors.forename: Sung-Jin
authors.initials: SJ
authors.lastname: Park
authors.affiliation: Department of Surgery, Postgraduate School of Medicine, Pusan National University, Busan, Korea.
authors.forename: Hyung-Il
authors.initials: HI
authors.lastname: Seo
authors.affiliation: Department of Surgery, Postgraduate School of Medicine, Pusan National University, Busan, Korea.
authors.forename: Soo-Hee
authors.initials: SH
authors.lastname: Go
authors.affiliation: Department of Surgery, Postgraduate School of Medicine, Pusan National University, Busan, Korea.
authors.forename: Sung-Pil
authors.initials: SP
authors.lastname: Yun
authors.affiliation: Department of Surgery, Postgraduate School of Medicine, Pusan National University, Busan, Korea.
authors.forename: Ji-Yeon
authors.initials: JY
authors.lastname: Lee
keywords: Complication; Distal pancreatectomy; Leak; Pancreatic fistula