Retroperitonealization of the pancreatic stump in distal pancreatectomy: a novel technique to reduce postoperative pancreatic fistula.
Distal pancreatectomy
Laparoscopy
Minimally invasive surgical procedures
Pancreatic fistula
Retroperitonealization
Journal
Langenbeck's archives of surgery
ISSN: 1435-2451
Titre abrégé: Langenbecks Arch Surg
Pays: Germany
ID NLM: 9808285
Informations de publication
Date de publication:
02 Nov 2023
02 Nov 2023
Historique:
received:
22
03
2023
accepted:
04
10
2023
medline:
3
11
2023
pubmed:
2
11
2023
entrez:
2
11
2023
Statut:
epublish
Résumé
To evaluate the efficacy and safety of retroperitonealization of the pancreatic stump in distal pancreatectomy. Clinical data from the Tongji Hospital pancreatic database were retrospectively reviewed in this study. The data of 68 patients who underwent retroperitonealized distal pancreatectomy from January, 2019, to April, 2021, were collected and analyzed. Sixty-four patients who underwent conventional distal pancreatectomy during the same period were matched. We compared and analyzed the operative outcomes and postoperative complications between the patients in the two groups before and after propensity score matching (PSM). Before PSM, the operative outcomes and postoperative complications were comparable between the two groups. After PSM, the retroperitonealized group had a lower incidence of postoperative pancreatic fistula (POPF) (10.53% vs 31.58%, P = 0.047) and shorter time until drainage removal (10.00, 8.00-13.00 days vs 13.00, 10.00-18.00 days, P = 0.005). In the univariate and multivariate regression analyses, non-retroperitonealization and intra-abdominal infection were found to be independent risk factors for postoperative pancreatic fistula (POPF). Retroperitonealization of the pancreatic stump can reduce the incidence of POPF after distal pancreatectomy.
Identifiants
pubmed: 37914974
doi: 10.1007/s00423-023-03138-2
pii: 10.1007/s00423-023-03138-2
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
425Subventions
Organisme : National Natural Science Foundation of China
ID : 81773160
Organisme : National Natural Science Foundation of China
ID : 81772950
Organisme : Natural Science Foundation of Hubei Province
ID : 2017CFB467
Organisme : Tongji Hospital Clinical Research Flagship Program
ID : 2019CR203
Informations de copyright
© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
Références
Postlewait LM, Kooby DA (2015) Laparoscopic distal pancreatectomy for adenocarcinoma: safe and reasonable? J Gastrointest Oncol 6(4):406–17
pubmed: 26261727
pmcid: 4502162
Gouillat C, Gigot JF (2001) Pancreatic surgical complications–the case for prophylaxis. Gut 49(Suppl 4):iv32-9
pubmed: 11878792
Maggino L et al (2019) Decoding grade B pancreatic fistula: a clinical and economical analysis and subclassification proposal. Ann Surg 269(6):1146–1153
doi: 10.1097/SLA.0000000000002673
pubmed: 31082914
Jiang L, Ning D, Chen X (2020) Prevention and treatment of pancreatic fistula after pancreatic body and tail resection: current status and future directions. Front Med 14(3):251–261
doi: 10.1007/s11684-019-0727-3
pubmed: 31840199
Mezhir JJ (2013) Management of complications following pancreatic resection: an evidence-based approach. J Surg Oncol 107(1):58–66
doi: 10.1002/jso.23139
pubmed: 22535571
Nakamura M et al (2014) Prediction of pancreatic fistula by preoperatively assessable factors; retrospective review of unified operations by single surgeon. Hepatogastroenterology 61(131):834–7
pubmed: 26176082
Harris LJ et al (2010) Optimal technical management of stump closure following distal pancreatectomy: a retrospective review of 215 cases. J Gastrointest Surg 14(6):998–1005
doi: 10.1007/s11605-010-1185-z
pubmed: 20306151
Diener MK et al (2011) Efficacy of stapler versus hand-sewn closure after distal pancreatectomy (DISPACT): a randomised, controlled multicentre trial. Lancet 377(9776):1514–22
doi: 10.1016/S0140-6736(11)60237-7
pubmed: 21529927
Montorsi M et al (2012) Efficacy of an absorbable fibrin sealant patch (TachoSil) after distal pancreatectomy: a multicenter, randomized, controlled trial. Ann Surg 256(5):853–9
doi: 10.1097/SLA.0b013e318272dec0
pubmed: 23095631
Kawai M et al (2016) Randomized controlled trial of pancreaticojejunostomy versus stapler closure of the pancreatic stump during distal pancreatectomy to reduce pancreatic fistula. Ann Surg 264(1):180–7
doi: 10.1097/SLA.0000000000001395
pubmed: 26473652
Probst P, Hüttner FJ, Klaiber U, Knebel P, Ulrich A, Büchler MW, Diener MK (2015) Stapler versus scalpel resection followed by hand-sewn closure of the pancreatic remnant for distal pancreatectomy. Cochrane Database Syst Rev 11:CD008688. https://doi.org/10.1002/14651858.CD008688.pub2
Kawai M et al (2017) Reinforced staplers for distal pancreatectomy. Langenbecks Arch Surg 402(8):1197–1204
doi: 10.1007/s00423-017-1634-1
pubmed: 29103084
Jang JY et al (2017) Effect of polyglycolic acid mesh for prevention of pancreatic fistula following distal pancreatectomy: a randomized clinical trial. JAMA Surg 152(2):150–155
doi: 10.1001/jamasurg.2016.3644
pubmed: 27784046
Uemura K et al (2017) Randomized clinical trial of duct-to-mucosa pancreaticogastrostomy versus handsewn closure after distal pancreatectomy. Br J Surg 104(5):536–543
doi: 10.1002/bjs.10458
pubmed: 28112814
Hassenpflug M et al (2016) Teres ligament patch reduces relevant morbidity after distal pancreatectomy (the DISCOVER randomized controlled trial). Ann Surg 264(5):723–730
doi: 10.1097/SLA.0000000000001913
pubmed: 27455155
Olah A et al (2009) Randomized clinical trial of techniques for closure of the pancreatic remnant following distal pancreatectomy. Br J Surg 96(6):602–7
doi: 10.1002/bjs.6620
pubmed: 19434697
Wang M et al (2014) Greater omentum binding: a simple technique to cover the pancreatic remnant after distal pancreatectomy. J Am Coll Surg 219(2):e19-23
doi: 10.1016/j.jamcollsurg.2014.01.066
pubmed: 25038967
Chen S, Chen G, Zhao Y (2018) Comment on ‘teres ligament patch reduces relevant morbidity after distal pancreatectomy (the DISCOVER randomized controlled trial).’ Ann Surg 267(5):e93–e94
doi: 10.1097/SLA.0000000000002200
pubmed: 28272100
Eckmann C et al (2004) Anastomotic leakage following low anterior resection: results of a standardized diagnostic and therapeutic approach. Int J Colorectal Dis 19(2):128–33
doi: 10.1007/s00384-003-0498-8
pubmed: 14752675
Mueller MG et al (2016) Outcomes in 450 women after minimally invasive abdominal sacrocolpopexy for pelvic organ prolapse. Female Pelvic Med Reconstr Surg 22(4):267–71
doi: 10.1097/SPV.0000000000000269
pubmed: 27054799
Varkarakis IM et al (2007) Evaluation of findings during re-exploration for obstructive ileus after radical cystectomy and ileal-loop urinary diversion: insight into potential technical improvements. BJU Int 99(4):893–7
doi: 10.1111/j.1464-410X.2006.06644.x
pubmed: 17155979
Bassi C et al (2017) The 2016 update of the International Study Group (ISGPS) definition and grading of postoperative pancreatic fistula: 11 Years After. Surgery 161(3):584–591
doi: 10.1016/j.surg.2016.11.014
pubmed: 28040257
Kleeff J et al (2007) Distal pancreatectomy: risk factors for surgical failure in 302 consecutive cases. Ann Surg 245(4):573–82
doi: 10.1097/01.sla.0000251438.43135.fb
pubmed: 17414606
pmcid: 1877036
Goh BK (2008) Re: Distal pancreatectomy: risk factors for surgical failure in 302 consecutive cases. Ann Surg 247(2):392–3
doi: 10.1097/SLA.0b013e318164022d
pubmed: 18216551
Martin AN et al (2018) Pancreatic duct size and gland texture are associated with pancreatic fistula after pancreaticoduodenectomy but not after distal pancreatectomy. PLoS One 13(9):e0203841
doi: 10.1371/journal.pone.0203841
pubmed: 30212577
pmcid: 6136772
Loos M et al (2018) Postoperative pancreatic fistula: microbial growth determines outcome. Surgery 164(6):1185–1190
doi: 10.1016/j.surg.2018.07.024
pubmed: 30217397
Yang F et al (2019) Drain contamination after distal pancreatectomy: incidence, risk factors, and association with postoperative pancreatic fistula. J Gastrointest Surg 23(12):2449–2458
doi: 10.1007/s11605-019-04155-7
pubmed: 30815778
Rieder B et al (2010) Endoscopic pancreatic sphincterotomy and stenting for preoperative prophylaxis of pancreatic fistula after distal pancreatectomy. Gastrointest Endosc 72(3):536–42
doi: 10.1016/j.gie.2010.04.011
pubmed: 20598301
Hackert T et al (2017) Sphincter of Oddi botulinum toxin injection to prevent pancreatic fistula after distal pancreatectomy. Surgery 161(5):1444–1450
doi: 10.1016/j.surg.2016.09.005
pubmed: 27865590
Kunstman JW et al (2019) Outcomes after pancreatectomy with routine pasireotide use. J Am Coll Surg 228(2):161-170 e2