scholarly journals Radiofrequency-induced heating versus mechanical stapler for pancreatic stump closure:in vivocomparative study

2016 ◽  
Vol 32 (3) ◽  
pp. 272-280 ◽  
Author(s):  
Fernando Burdío ◽  
Dimitri Dorcaratto ◽  
Lourdes Hernandez ◽  
Anna Andaluz ◽  
Xavier Moll ◽  
...  
Keyword(s):  
Pancreatic Stump ◽  
Mechanical Stapler

scholarly journals Wrapping the pancreas with a polyglycolic acid sheet before stapling reduces the risk of fluid collection on the pancreatic stump after distal pancreatectomy

2021 ◽  
Author(s):  
Ji Su Kim ◽  
Seoung Yoon Rho ◽  
Dong Min Shin ◽  
Munseok Choi ◽  
Chang Moo Kang ◽  
...  
Keyword(s):  
Pancreatic Fistula ◽  
Distal Pancreatectomy ◽  
Fluid Collection ◽  
International Study ◽  
Polyglycolic Acid ◽  
Previous Method ◽  
Tertiary Referral ◽  
Tertiary Referral Hospital ◽  
Pancreatic Stump ◽  
Resection Line

Abstract Background Postoperative pancreatic fistula (POPF) and postoperative fluid collection (POFC) are common complications after distal pancreatectomy (DP). The previous method of reducing the risk of POPF was the application of a polyglycolic acid (PGA) sheet to the pancreatic stump after cutting the pancreas with a stapler (After-stapling); the new method involves wrapping the pancreatic resection line with a PGA sheet before stapling (Before-stapling). The study aimed to compare the incidence of POPF and POFC between two methods. Methods Data of patients who underwent open or laparoscopic DPs by a single surgeon from October 2010 to February 2020 in a tertiary referral hospital were retrospectively analyzed. POPF was defined according to the updated International Study Group of Pancreatic Fistula criteria. POFC was measured by postoperative computed tomography (CT). Results Altogether, 182 patients were enrolled (After-stapling group, n = 138; Before-stapling group, n = 44). Clinicopathologic and intraoperative findings between the two groups were similar. Clinically relevant POPF rates were similar between both groups (4.3% vs. 4.5%, p = 0.989). POFC was significantly lesser in the Before-stapling group on postoperative day 7 (p < 0.001). Conclusions Wrapping the pancreas with PGA sheet before stapling was a simple and effective way to reduce POFC.

Pancreaticogastrostomy after Pancreaticoduodenectomy Using Twin Square Wrapping with Duct-to-Mucosa Anastomosis

2015 ◽  
Vol 55 (1-2) ◽  
pp. 109-118 ◽  
Author(s):  
Kosei Maemura ◽  
Yuko Mataki ◽  
Hiroshi Kurahara ◽  
Shinichiro Mori ◽  
Naotomo Higo ◽  
...  
Keyword(s):  
Operating Time ◽  
Conventional Group ◽  
C Reactive Protein ◽  
Pancreatic Anastomosis ◽  
Pancreatic Stump ◽  
Reactive Protein ◽  
Significant Difference ◽  
Pancreatic Fistulas ◽  
Hospital Stays ◽  
Blood Loss Volume

Background/Purpose: This study aimed to evaluate the feasibility and safety of a novel pancreaticogastrostomy technique for diminishing pancreatic fistulas after pancreaticoduodenectomy using gastric wrapping of the pancreatic stump with a twin square-shaped horizontal mattress and a suture fixing the main pancreatic duct to the gastric mucosa anastomosis [twin square wrapping (TSW) method]. Methods: Fifty-three patients undergoing pancreaticogastrostomy after pancreaticoduodenectomy were included in the study and chronologically divided into a conventional group (n = 32) and a TSW group (n = 21). The perioperative factors and the postoperative outcomes were retrospectively analyzed. Results: The operating time for the pancreatic anastomosis, the total operating time, and the blood loss volume in the TSW group were lower than in the conventional group, but without a statistically significant difference. The TSW group had a significantly lower postoperative white blood cell count and C-reactive protein level, with a reduced intra-abdominal fluid accumulation as assessed by computed tomography on postoperative day 7, had a lower incidence of postoperative complications and pancreatic fistulas, and achieved a shorter duration of drain placement and shorter postoperative hospital stays as compared to the conventional group. Conclusions: The TSW technique should be considered for reducing pancreatic fistulas by diminishing the postoperative inflammatory response and improving patient outcomes without increasing the operating time.

scholarly journals Intraoperative Visualization of Pancreatic Juice Leaking From the Pancreatic Stump in a Swine Model

2015 ◽  
Vol 149 (6) ◽  
pp. 1334-1336 ◽  
Author(s):  
Kazuhiro Mori ◽  
Takeaki Ishizawa ◽  
Suguru Yamashita ◽  
Mako Kamiya ◽  
Yasuteru Urano ◽  
...  
Keyword(s):  
Pancreatic Juice ◽  
Swine Model ◽  
Pancreatic Stump ◽  
Intraoperative Visualization

Indications and results of pancreatic stump duct occlusion after duodenopancreatectomy

2016 ◽  
Vol 68 (3) ◽  
pp. 287-293 ◽  
Author(s):  
Sergio Alfieri ◽  
Giuseppe Quero ◽  
Fausto Rosa ◽  
Dario Di Miceli ◽  
Antonio Pio Tortorelli ◽  
...  
Keyword(s):  
Pancreatic Stump ◽  
Duct Occlusion

scholarly journals Comparison between endoloop and linear mechanical stapler for the appendicular stump closure

2019 ◽  
Vol 86 (5) ◽  
Author(s):  
Juan J. Granados-Romero ◽  
Alan I. Valderrama-Treveriño ◽  
Baltazar Barrera-Mera ◽  
Karen Uriarte-Ruíz ◽  
Rodrigo Banegas-Ruiz ◽  
...  
Keyword(s):  
Stump Closure ◽  
Mechanical Stapler ◽  
Appendicular Stump ◽  
Appendicular Stump Closure

scholarly journals Short-and long-term results of distal pancreatectomy

2019 ◽  
Vol 36 (2) ◽  
pp. 6-13
Author(s):  
V. N. Barykov ◽  
A. G. Istomin ◽  
R. R. Abdrashitov ◽  
A. S. Ryzhikh
Keyword(s):  
Distal Pancreatectomy ◽  
Long Term Results ◽  
Benign Tumors ◽  
Pancreatic Stump ◽  
Pancreatogenic Diabetes ◽  
Pancreatic Fistulas ◽  
Short And Long Term ◽  
Wirsung Duct ◽  
One Year

Aim. To assess the results of distal pancreatectomy for malignant and benign tumors and chronic pancreatitis complications. Materials and methods. Forty-seven patients, who underwent distal pancreatectomy, were under observation during the period from 01.01.2008 to 28.02.2019. Results. The long-term results of surgical treatment demonstrated the following complications: pancreatic fistulas – 15 % of observations, pancreatogenic diabetes mellitus – 12.7 %, subphrenic abscesses – 10 %. In the long-term period after the surgery – from 10 years and not less than one year – 30 patients were followed up, constituting 63.8 % of the total number. Conclusions. To prevent complications in the form of pancreatic fistula with pathological Wirsung duct dilatation more than 4–5 mm in diameter, it is necessary to form anastomosis between the pancreatic stump and the small bowel.

scholarly journals Postoperative Outcomes Analysis After Pancreatic Duct Occlusion: A Safe Option to Treat the Pancreatic Stump After Pancreaticoduodenectomy in Low-Volume Centers

2021 ◽  
Vol 8 ◽  
Author(s):  
Antonio Giuliani ◽  
Pasquale Avella ◽  
Anna Lucia Segreto ◽  
Maria Lucia Izzo ◽  
Antonio Buondonno ◽  
...  
Keyword(s):  
Pancreatic Duct ◽  
Postoperative Outcomes ◽  
Cyanoacrylate Glue ◽  
Pancreatic Anastomosis ◽  
Pancreatic Stump ◽  
Pancreatic Duct Occlusion ◽  
Duct Occlusion ◽  
Whipple’S Procedure ◽  
The Mean

Background: Surgical resection is the only possible choice of treatment in several pancreatic disorders that included periampullar neoplasms. The development of a postoperative pancreatic fistula (POPF) is the main complication. Despite three different surgical strategies that have been proposed–pancreatojejunostomy (PJ), pancreatogastrostomy (PG), and pancreatic duct occlusion (DO)–none of them has been clearly validated to be superior. The aim of this study was to analyse the postoperative outcomes after DO.Methods: We retrospectively reviewed 56 consecutive patients who underwent Whipple's procedure from January 2007 to December 2014 in a tertiary Hepatobiliary Surgery and Liver Transplant Unit. After pancreatic resection in open surgery, we performed DO of the Wirsung duct with Cyanoacrylate glue independently from the stump characteristics. The mean follow-up was 24.5 months.Results: In total, 29 (60.4%) were men and 19 were (39.6%) women with a mean age of 62.79 (SD ± 10.02) years. Surgical indications were in 95% of cases malignant diseases. The incidence of POPF after DO was 31 (64.5%): 10 (20.8%) patients had a Grade A fistula, 18 (37.5%) Grade B fistula, and 3 (6.2%) Grade C fistula. No statistical differences were demonstrated in the development of POPF according to pancreatic duct diameter groups (p = 0.2145). Nevertheless, the POPF rate was significantly higher in the soft pancreatic group (p = 0.0164). The mean operative time was 358.12 min (SD ± 77.03, range: 221–480 min). Hospital stay was significantly longer in patients who developed POPF (p &lt; 0.001). According to the Clavien-Dindo (CD) classification, seven of 48 (14.58%) patients were classified as CD III–IV. At the last follow-up, 27 of the 31 (87%) patients were alive.Conclusions: Duct occlusion could be proposed as a safe alternative to pancreatic anastomosis especially in low-/medium-volume centers in selected cases at higher risk of clinically relevant POPF.

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