Journals / Turkish Journal of Gastroenterology / 2018 / Cilt: 29 - Sayı: 2

Pancreatic stump closure using only stapler is associated with high postoperative fistula rate after minimal invasive surgery

Pages
191–197
DOI
—
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⚡ TL;DR(Too Long; Didn't Read)

A total of 96 patients who underwent DP were retrospectively analyzed.Results: Overall, 24 patients (25%) underwent laparoscopic distal pancreatectomy (LDP) and 72 patients (75%) open surgery.

📌 3 Key Takeaways

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Objective & Hypothesis:Background/Aims: Postoperative pancreatic fistula (POPF) is the most common cause of morbidity and mortality after distal pancre-atectomy (DP).
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Key Findings & Data:The aim of the present study is to determine the risk factors that can lead to POPF.Materials and Methods: The study was conducted between January 2008 and December 2012.
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Conclusion & Impact:A total of 96 patients who underwent DP were retrospectively analyzed.Results: Overall, 24 patients (25%) underwent laparoscopic distal pancreatectomy (LDP) and 72 patients (75%) open surgery.
🔬Design:Research Article
📍Scope:2008 Verileri
⚙️Variables:Domain Parameters

Özet

Background/Aims: Postoperative pancreatic fistula (POPF) is the most common cause of morbidity and mortality after distal pancre-atectomy (DP). The aim of the present study is to determine the risk factors that can lead to POPF.Materials and Methods: The study was conducted between January 2008 and December 2012. A total of 96 patients who underwent DP were retrospectively analyzed.Results: Overall, 24 patients (25%) underwent laparoscopic distal pancreatectomy (LDP) and 72 patients (75%) open surgery. The over-all morbidity rate was 51% (49/96). POPF (32/96, 33.3%) was the most common postoperative complication. Grade B fistula (18/32, 56.2%) was the most common fistula type according to the International Study Group on Pancreatic Fistula definition. POPF rate was significantly higher in the minimally invasive surgery group (50%, p=0.046). POPF rate was 58.6% (17/29) in patients whose pancre-atic stump closure was performed with only stapler, whereas POPF rate was 3.6% (1/28) in the group where the stump was closed with stapler plus oversewing sutures. Both minimally invasive surgery (OR: 0.286, 95% CI: 0.106-0.776, p=0.014) and intraoperative blood transfusion (OR: 4.210, 95% CI: 1.155-15.354, p=0.029) were detected as independent risk factors for POPF in multi-variety analysis.Conclusion: LDP is associated with a higher risk of POPF when stump closure is performed with only staplers. Intraoperative blood trans-fusion is another risk factor for POPF. On the other hand, oversewing sutures to the stapler line reduces the risk of POPF.

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Cite This Article

YÜKSEL, A., BOSTANCI, E. B., ÇOLAKOĞLU, M. K., ULAŞ, M., ÖZER, İ., KARAMAN, K., AKOĞLU, M. (2018). Pancreatic stump closure using only stapler is associated with high postoperative fistula rate after minimal invasive surgery. Turkish Journal of Gastroenterology, Cilt: 29 - Sayı: 2, 191–197. https://ajindex.com/articles/410078

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