title: Preventing pancreatic fistula after distal pancreatectomy: An invagination method.
abstract: Following an increase in the use of the GIA stapler for treating a pancreatic stump, more techniques to prevent postoperative pancreatic juice leakage have been required. We describe one successful case using our new technique of invaginating the cut end of the pancreas into the stomach to prevent a pancreatic fistula (PF) from occurring. A 50-year-old woman with pancreatic cancer in the tail of the pancreas underwent distal pancreatectomy, causing a grade A PF. We resected the distal pancreas without additional reinforcement to invaginate the stump into the gastric posterior wall with single layer anastomosis using a 3-0 absorbable suture. The drain tubes were removed on the third postoperative day. Although a grade A PF was noted, the patient was discharged on foot on the eleventh postoperative day. Our technique may be a suitable method for patients with a pancreatic body and tail tumor.
authors.affiliation: Nagato Katsura, Takahiko Hoashi, Seijun Fukuda, Kenji Shimizu, Department of Surgery, Misugikai Otokoyama Hospital, Otokoyama Izumi, Yawata, Kyoto 614-8366, Japan.
authors.forename: Nagato
authors.initials: N
authors.lastname: Katsura
authors.affiliation: Nagato Katsura, Takahiko Hoashi, Seijun Fukuda, Kenji Shimizu, Department of Surgery, Misugikai Otokoyama Hospital, Otokoyama Izumi, Yawata, Kyoto 614-8366, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Kawai
authors.affiliation: Nagato Katsura, Takahiko Hoashi, Seijun Fukuda, Kenji Shimizu, Department of Surgery, Misugikai Otokoyama Hospital, Otokoyama Izumi, Yawata, Kyoto 614-8366, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Gomi
authors.affiliation: Nagato Katsura, Takahiko Hoashi, Seijun Fukuda, Kenji Shimizu, Department of Surgery, Misugikai Otokoyama Hospital, Otokoyama Izumi, Yawata, Kyoto 614-8366, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Okumura
authors.affiliation: Nagato Katsura, Takahiko Hoashi, Seijun Fukuda, Kenji Shimizu, Department of Surgery, Misugikai Otokoyama Hospital, Otokoyama Izumi, Yawata, Kyoto 614-8366, Japan.
authors.forename: Takahiko
authors.initials: T
authors.lastname: Hoashi
authors.affiliation: Nagato Katsura, Takahiko Hoashi, Seijun Fukuda, Kenji Shimizu, Department of Surgery, Misugikai Otokoyama Hospital, Otokoyama Izumi, Yawata, Kyoto 614-8366, Japan.
authors.forename: Seijun
authors.initials: S
authors.lastname: Fukuda
authors.affiliation: Nagato Katsura, Takahiko Hoashi, Seijun Fukuda, Kenji Shimizu, Department of Surgery, Misugikai Otokoyama Hospital, Otokoyama Izumi, Yawata, Kyoto 614-8366, Japan.
authors.forename: Katsushi
authors.initials: K
authors.lastname: Takebayashi
authors.affiliation: Nagato Katsura, Takahiko Hoashi, Seijun Fukuda, Kenji Shimizu, Department of Surgery, Misugikai Otokoyama Hospital, Otokoyama Izumi, Yawata, Kyoto 614-8366, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Shimizu
authors.affiliation: Nagato Katsura, Takahiko Hoashi, Seijun Fukuda, Kenji Shimizu, Department of Surgery, Misugikai Otokoyama Hospital, Otokoyama Izumi, Yawata, Kyoto 614-8366, Japan.
authors.forename: Masugi
authors.initials: M
authors.lastname: Satoh
mesh_terms: D004322:Drainage / Q000009:adverse effects; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000737:chemistry; D006801:Humans; D008875:Middle Aged; D010179:Pancreas / Q000601:surgery*; D010180:Pancreatectomy / Q000009:adverse effects; D010185:Pancreatic Fistula / Q000517:prevention & control*; D010189:Pancreatic Juice; D010190:Pancreatic Neoplasms / Q000601:surgery; D049268:Positron-Emission Tomography; D011184:Postoperative Period; D013536:Suture Techniques / Q000009:adverse effects; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D019788:Fluorodeoxyglucose F18
keywords: Amylases; Neoplasms; Pancreatectomy; Pancreatic fistula; Pancreatic juice