A thick pancreas is a risk factor for pancreatic fistula after a distal pancreatectomy: Selection of the closure technique according to the thickness

Hidetoshi Eguchi, Hiroaki Nagano, Masahiro Tanemura, Yutaka Takeda, Shigeru Marubashi, Shogo Kobayashi, Hiroshi Wada, Koji Umeshita, Masaki Mori, Yuichiro Doki

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Abstract

Background/Aims: Hand-sewn closures or stapler closures of the pancreatic remnant after a distal pancreatectomy have commonly been employed; however, the choice of technique in each patient depending on their clinical characteristics has not been discussed. Methods: Forty-eight patients who underwent a distal pancreatectomy at Osaka University Hospital between January 2007 and October 2009 were enrolled. A hand-sewn closure was planned during the 1st period (before June 2008, 26 consecutive patients), whereas a stapler closure was planned for the 2nd period (after June 2008, 22 consecutive patients). The incidence of pancreatic fistula and the patients' characteristics were retrospectively investigated. Results: Seven patients (27%) developed a fistula in the hand-sewn group, while 5 (23%) developed a fistula in the stapler group (p = n.s.). Using logistic regression analysis for all patients, younger age and the thickness of the pancreatic remnant were identified as independent risk factors for pancreatic fistula. In the stapler group, 50% of patients with a thick pancreas developed a pancreatic fistula, while no patients with a thin pancreas developed one. Conclusion: Thick pancreas is one of the risk factors for pancreatic fistula after a distal pancreatectomy; however, a stapler closure seems to be suitable at least for thin pancreas.

Original languageEnglish
Pages (from-to)50-56
Number of pages7
JournalDigestive surgery
Volume28
Issue number1
DOIs
Publication statusPublished - Mar 1 2011

All Science Journal Classification (ASJC) codes

  • Surgery
  • Gastroenterology

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    Eguchi, H., Nagano, H., Tanemura, M., Takeda, Y., Marubashi, S., Kobayashi, S., Wada, H., Umeshita, K., Mori, M., & Doki, Y. (2011). A thick pancreas is a risk factor for pancreatic fistula after a distal pancreatectomy: Selection of the closure technique according to the thickness. Digestive surgery, 28(1), 50-56. https://doi.org/10.1159/000322406