Closure of the distal pancreatic stump with a seromuscular flap

Moriura, Shigeaki; Kimura, Atsushi; Ikeda, Shuhei; Iwatsuka, Yasushi; Ikezawa, Teruo; Naiki, Kenichi

doi:10.1007/bf00312391

Cited by 38 publications

(27 citation statements)

References 6 publications

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“…Numerous attempts have been described to avoid fistula formation, such as handsewn suture of the cut end, stapler closure, ligation of the main pancreatic duct 7,8 , stapler closure of the remnant using absorbable staples 9 , pancreas banding 10 , pancreaticoenteric anastomosis 11 , use of ultrasonic dissection devices 12,13 or seromuscular patches 14,15 , fibrin glue sealing 16,17 , application of surface active meshes 18 and combinations of these techniques.…”

Section: Introductionmentioning

confidence: 99%

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Randomized clinical trial of techniques for closure of the pancreatic remnant following distal pancreatectomy

Oláh

Issekutz

Belágyi

et al. 2009

British Journal of Surgery

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Section: Introductionmentioning

confidence: 99%

“…Following distal pancreatectomy, closure of the pancreatic remnant with a patch has been described using either an isolated Roux-n-Y loop 14 or gastric serosa 15 . A combination of the stapler technique and coverage by a seromuscular patch may provide a simple solution to the problem.…”

Section: Introductionmentioning

confidence: 99%

Randomized clinical trial of techniques for closure of the pancreatic remnant following distal pancreatectomy

Oláh

Issekutz

Belágyi

et al. 2009

British Journal of Surgery

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“…Moriura et al reported that pancreas-related complications decreased when using a seromuscular patch. 71 However, these results have not been confirmed in the randomized controlled trial by Olah et al, in which grade B/C postoperative pancreatic fistulas after stapled transection and stapled transection combined with a seromuscular patch were found to be similar. 72 In addition, the application of a falciform ligament patch and fibrin glue to standard stapled or sutured remnant closure did not reduce the rate of postoperative pancreatic fistula in patients undergoing DP.…”

Section: Glue and Patchesmentioning

confidence: 87%

Minimally Invasive Distal Pancreatectomy: Review of the English Literature

Wang

Fan

2017

Journal of Laparoendoscopic & Advanced Surgical Techniques

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“…Ultrasonic dissection devices in particular are easily available and also significantly reduce the occurrence of PF in DP [8] . Seromuscular patches [11] , fibrin glue sealing [12] , the application of surface-active meshes, and combinations of these techniques [13] were used for closure of the pancreas.…”

Section: Resection Of the Pancreas Closure Of The Remnant Pancreas mentioning

confidence: 99%

“…Seromuscular patch closure of the pancreatic remnant has been described using either an isolated Rouxn-Y loop [11] or gastric serosa [14] . Hassenpflug et al [15] reported that coverage of the pancreatic remnant after DP decreased the occurrence of clinically relevant PF.…”

Section: Resection Of the Pancreas Closure Of The Remnant Pancreas mentioning

confidence: 99%

Perioperative management of distal pancreatectomy

Fujino¹

2015

WJG

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Recent advances in surgical techniques and perioperative management have markedly reduced operative morbidity after distal pancreatectomy (DP). However, some questions remain regarding the protocol for the perioperative management of DP, in particular, with regard to the development of pancreatic fistula (PF). A review of DP was therefore conducted in order to standardize the management of patients for a favorable outcome. Overall, operative technique and perioperative management emerged as two critical factors contributing to favorable outcome in DP patients. As for the operative method, surgical and closure techniques exhibited differences in outcome. Laparoscopic DP generally yields more favorable perioperative outcomes compared to open DP, and is applicable for benign tumors and some ductal carcinomas of the pancreas. Robotic DP is also available for safe pancreatic surgery. En bloc celiac axis resection offers a high R0 resection rate and potentially allows for some local control in the case of advanced pancreatic cancer. Following resection, staple closure was not found to reduce the rate of PF when compared to hand-sewn closure. In addition, ultrasonic dissection devices, fibrin glue sealing, and staple closure with mesh reinforcement were shown to significantly reduce PF, although there was some bias in these studies. In perioperative management, both preoperative and postoperative treatment affected outcome. First, preoperative endoscopic pancreatic stenting may be an effective prophylactic measure against fistula development following DP in selected patients. Second, in postoperative management, a multifactorial approach including prophylactic antibiotics improved high surgical site infection rates following complex hepato-pancreatobiliary surgery. Furthermore, although conflicting results have been reported, somatostatin analogues should be administered selectively to patients considered to have a high risk for PF. Finally, careful drain management also facilitates a favorable outcome in patients with PF after DP. The results of the review indicate that laparoscopic DP coupled with perioperative management influences outcome in DP patients. Core tip: Perioperative management of distal pancreatectomy has been reviewed in order to standardize management for a favorable outcome in these patients.Fujino Y. Perioperative management of distal pancreatectomy.

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Closure of the distal pancreatic stump with a seromuscular flap

Cited by 38 publications

References 6 publications

Randomized clinical trial of techniques for closure of the pancreatic remnant following distal pancreatectomy

Randomized clinical trial of techniques for closure of the pancreatic remnant following distal pancreatectomy

Minimally Invasive Distal Pancreatectomy: Review of the English Literature

Perioperative management of distal pancreatectomy

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