Use of a Reinforced Triple-row Stapler Following Distal Pancreatectomy Reduces the Incidence of Postoperative Pancreatic Fistula in Patients With a High BMI

Although perioperative management and operative techniques for pancreatic surgery have improved, postoperative pancreatic fistula (POPF) remains the major cause of morbidity and mortality following distal pancreatectomy (DP). The purpose of this study was to evaluate the superiority of the reinforce...

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Bibliographic Details
Published in:Anticancer research 2019-02, Vol.39 (2), p.1013-1018
Main Authors: Kawaida, Hiromichi, Kono, Hiroshi, Amemiya, Hidetake, Hosomura, Naohiro, Saito, Ryo, Takahashi, Kazunori, Yamamoto, Atsushi, Watanabe, Mitsuaki, Furuya, Shinji, Shimizu, Hiroki, Akaike, Hidenori, Kawaguchi, Yoshihiko, Sudo, Makoto, Matusda, Masanori, Itakura, Jun, Fujii, Hideki, Ichikawa, Daisuke
Format: Article
Language:English
Subjects:
Aged
Body mass
Body Mass Index
Female
Fistula
Fistulae
Humans
Incidence
Male
Middle Aged
Morbidity
Obesity - complications
Obesity - surgery
Pancreas
Pancreatectomy
Pancreatectomy - adverse effects
Pancreatectomy - instrumentation
Pancreatectomy - methods
Pancreatic Fistula - etiology
Pancreatic Fistula - prevention & control
Postoperative Complications - etiology
Postoperative Complications - prevention & control
Prospective Studies
Risk Factors
Surgery
Surgical Staplers
Surgical Stapling - adverse effects
Surgical Stapling - instrumentation
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Summary:Although perioperative management and operative techniques for pancreatic surgery have improved, postoperative pancreatic fistula (POPF) remains the major cause of morbidity and mortality following distal pancreatectomy (DP). The purpose of this study was to evaluate the superiority of the reinforced stapler compared to the bare triple row stapler. A total of 93 patients who underwent DP at the First Department of Surgery at Yamanashi University were examined. The patients were divided into two groups according to the closure method for the pancreatic stump; the bare triple-row stapler (BTRS) group and the reinforced triple-row stapler (RTRS) group. The postoperative outcomes were then compared in terms of several clinicopathological factors between the two groups. Seven patients were diagnosed with Grade B/C POPF in this series. The incidence of POPF in the RTRS group was lower than that in the BTRS group (3.6% vs. 13.5%), although there was no significant difference (p=0.077). Further detailed analysis demonstrated that RTRS significantly reduced POPF compared to BTRS in obese patients with a BMI >25.0 kg/m (p=0.038). Reinforced triple-row staplers may reduce the incidence of severe POPF, especially in obese patients with a BMI >25 kg/m .
ISSN:0250-7005
1791-7530
DOI:10.21873/anticanres.13207