Gastric serosal patch in distal pancreatectomy for injury: a neglected technique

Kluger, Yoram; Alfici, Ricardo; Abbley, B.; Soffer, Dror; Aladgem, David

doi:10.1016/s0020-1383(96)00157-x

Cited by 23 publications

(14 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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“…Several surgical resection and closure techniques have been introduced for the pancreatic remnant in an attempt to reduce complications, and in particular pancreatic fistulas. These include hand-sewn suture techniques, stapled closure techniques, or a combination of both [11][12][13][14][15][16] ; ultrasonic dissection devices, 17 pancreaticoenteric anastomosis, 18 application of meshes, seromuscular 19 and gastric serosa patches, 20 or sealing with fibrin glue. 21,22 The objective of this study was to analyze factors contributing to postoperative mortality and morbidity following distal pancreatectomy.…”

mentioning

confidence: 99%

Distal Pancreatectomy

Kleeff¹,

Diener²,

Z’graggen³

et al. 2007

Annals of Surgery

366

139

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“…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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Gastric serosal patch in distal pancreatectomy for injury: a neglected technique

Cited by 23 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

Distal Pancreatectomy

Perioperative management of distal pancreatectomy

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