Prolonged peri-firing compression with a linear stapler prevents pancreatic fistula in laparoscopic distal pancreatectomy

Surg Endosc. 2011 Mar;25(3):867-71. doi: 10.1007/s00464-010-1285-6. Epub 2010 Aug 21.

Abstract

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.

Patients and 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.

Publication types

  • Evaluation Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Amylases / blood
  • Equipment Design
  • Female
  • Humans
  • Incidence
  • Laparoscopy / methods*
  • Laparotomy
  • Length of Stay / statistics & numerical data
  • Male
  • Middle Aged
  • Pancreatectomy / methods*
  • Pancreatic Fistula / epidemiology
  • Pancreatic Fistula / prevention & control*
  • Postoperative Complications / epidemiology
  • Postoperative Complications / prevention & control*
  • Pressure
  • Retrospective Studies
  • Suction
  • Surgical Staplers*
  • Surgical Stapling / methods*
  • Young Adult

Substances

  • Amylases