Morbidity, mortality, and technical factors of distal pancreatectomy

Fahy, Bridget N.; Frey, Charles F.; Ho, Hung S.; Beckett, Laurel A.; Bold, Richard J.

doi:10.1016/s0002-9610(02)00790-0

Cited by 219 publications

(189 citation statements)

References 12 publications

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“…In this study, we support that DP can be performed with low perioperative mortality (1.5%), while the incidence of pancreatic fistula, which was the most common postoperative complication, was 22%. These results are in accordance with the most authors' conclusions [3,4,[7][8][9] . In the past, in most of published studies there was no definition of pancreatic fistula and the diagnostic criteria for this had not yet been completely established.…”

Section: Discussionsupporting

confidence: 93%

“…However, there was no significant difference according to the incidence of pancreatic fistula in our study in comparison with the literature studies [3,4,[7][8][9] . Many authors state that the texture of the pancreatic parenchyma seems generally to be one of the most important risk factors responsible for the increased rate of pancreatic fistula [2,9] . The fibrotic pancreatic tissue is believed to be less likely to pancreatic leakage.…”

Section: T a B L E 4 I N C I D E N C E O F P A N C R E A T I C F I S contrasting

confidence: 84%

“…They observed that using the stapler technique had better results in comparison with the suture closure (stapler 14% vs hand suture 33%). Takeuchi et al [1] described a statistically significant reduction in fistula rate after stapler closure, Fahy et al [9] described suture closure as a risk factor for pancreatic fistula, while Sheehan et al [2] found that the suture closure of the pancreatic remnant was superior compared with the stapler closure (25% vs 14% respectively). Finally, Kajiyama et al [15] and Bilimoria et al [7] found no differences between the two techniques.…”

Section: T a B L E 4 I N C I D E N C E O F P A N C R E A T I C F I S mentioning

confidence: 99%

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Risk factors associated with pancreatic fistula after distal pancreatectomy, which technique of pancreatic stump closure is more beneficial?

Ridolfini

Alfieri²,

Gourgiotis³

et al. 2007

WJG

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AIM:To identify risk factors related to pancreatic fistula in patients undergoing distal pancreatectomy (DP) and to determine the effectiveness of using a stapled and a sutured closed of pancreatic stump. METHODS:Sixty-four patients underwent DP during a 10-year period. Information regarding diagnosis, operative details, and perioperative morbidity or mortality was collected. Eight risk factors were examined. RESULTS:Indications for DP included primary pancreatic disease (n = 38, 59%) and non-pancreatic malignancy (n = 26, 41%). Postoperative mortality and morbidity rates were 1.5% and 37% respectively; one patient died due to sepsis and two patients required a reoperation due to postoperative bleeding. Pancreatic fistula was developed in 14 patients (22%); 4 of fistulas were classified as Grade A, 9 as Grade B and only 1 as Grade C. Incidence of pancreatic fistula rate was significantly associated with four risk factors: pathology, use of prophylactic octreotide therapy, concomitant splenectomy, and texture of pancreatic parenchyma. The role that technique (either stapler or suture) of pancreatic stump closure plays in the development of pancreatic leak remains unclear. CONCLUSION:The pancreatic fistula rate after DP is 22%. This is reduced for patients with non-pancreatic malignancy, fibrotic pancreatic tissue, postoperative prophylactic octreotide therapy and concomitant splenectomy.

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Section: Discussionsupporting

confidence: 93%

Section: T a B L E 4 I N C I D E N C E O F P A N C R E A T I C F I S contrasting

confidence: 84%

Section: T a B L E 4 I N C I D E N C E O F P A N C R E A T I C F I S mentioning

confidence: 99%

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Risk factors associated with pancreatic fistula after distal pancreatectomy, which technique of pancreatic stump closure is more beneficial?

Ridolfini

Alfieri²,

Gourgiotis³

et al. 2007

WJG

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show abstract

“…This is in agreement with multiple prior studies, which indicate that closure of the pancreatic stump fails in 12-31 % of non-PSD patients undergoing DP. [17][18][19][20] Thus, chemoperfusion in the current study was not associated with a clinically significant increase in PF rate.…”

Section: Discussionmentioning

confidence: 59%

Impact of Distal Pancreatectomy on Outcomes of Peritoneal Surface Disease Treated with Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy

Clark

Randle

Swett

et al. 2014

Journal of Surgical Research

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“…PF may lead to an intra-abdominal abscess and bleeding. [1,2] DP usually consists of the resection of pancreatic parenchyma without portal vein resection. DP may be performed with or without splenectomy in cases of benign lesions and left renal mass surgery.…”

Section: Introductionmentioning

confidence: 99%

Recurrent pancreatic fistula occurring after nephrectomy in patients with a renal hydatid cyst

Ceylan

Odabaş

Doğan

et al. 2013

Turkish Journal of Urology

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Pancreatic fistula (PF) is an important complication that may develop during intra-abdominal surgeries and following distal pancreas trauma. In the early period, drainage from the surgical site and increased amylase production based on the biochemical examination of the drainage fluid are the factors for diagnosis. In contrast, in association with fluid collected from the surgical site, intra-abdominal abscess and high fever may lead to the diagnosis in the late period. Endoscopic retrograde cholangiopancreatography (ERCP) for the treatment of intra-abdominal fluid collection after PF and intra-abdominal percutaneous stent placement as well as the placement of a pancreatic stent in the pancreatic channel may be alternative methods to stop drainage. However, the complete resolution of fluid drainage may take months. In our case, drainage from the pancreatic fistula area took longer to resolve than the periods previously reported in the English literature. The tail of the pancreas can be injured during the extraction of especially aggressive and metastatic masses from organs near to the distal pancreas. Injury to the tail of the pancreas can also occur during the extraction of benign-like renal hydatid cysts and/or malignant left kidney masses. However, PF can be treated with noninvasive methods, such as percutaneous treatment and ERCP.

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Morbidity, mortality, and technical factors of distal pancreatectomy

Cited by 219 publications

References 12 publications

Risk factors associated with pancreatic fistula after distal pancreatectomy, which technique of pancreatic stump closure is more beneficial?

Risk factors associated with pancreatic fistula after distal pancreatectomy, which technique of pancreatic stump closure is more beneficial?

Impact of Distal Pancreatectomy on Outcomes of Peritoneal Surface Disease Treated with Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy

Recurrent pancreatic fistula occurring after nephrectomy in patients with a renal hydatid cyst

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