Use of the Round Ligament of the Liver to Decrease Pancreatic Fistulas: A Novel Technique

Iannitti, David A.; Coburn, Natalie; Somberg, Joy; Ryder, Beth A.; Monchik, Jack M.; Cioffi, William G.

doi:10.1016/j.jamcollsurg.2006.08.021

Cited by 74 publications

(72 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Iannitti et al [46] described the technique first in a retrospective analysis in 2006 with PF rate of only 5.3%, (although the development of PF was only investigated in the first postoperative week). Walters et al [47] used similar technique in a small cohort with a POPF rate of 8.7%.…”

Section: Coverage Of the Pancreatic Remnantmentioning

confidence: 99%

A Review of Techniques for Closure of the Pancreatic Remnant following Distal Pancreatectomy

et al. 2016

View full text Add to dashboard Cite

The prevalence of pancreatic diseases needing surgical intervention is continuously rising. Distal pancreatectomy is performed in the case of pathologies affecting the left side of the pancreas. More and more sophisticated surgical techniques have appeared and an increasing number of published articles discuss the possibilities for closure of the pancreatic remnant. However, the optimum solution is still under debate, as none of the examined techniques have been proven superior in reducing the incidence of the most common surgical complication, the formation of a postoperative pancreatic fistula (PF). Fistula rates have been stationary at 20-30% in the past decades despite the apparent advancement of medicine. This review presents a survey of the relevant articles examining different closure strategies and risk factors to reduce fistula formation rate. International medical publication database search and assessment was carried out to include the findings of studies investigating the efficacy of pancreatic remnant closure techniques to gain a clearer view on the complexity of pancreas fistulas. Emphasis is on indications for surgery, risk factors for postoperative fistula formation and strategies to seal the pancreatic remnant to avoid leakage. Findings suggest that careful patient selection, meticulous surgical techniques are equally important to reduce fistula rates. Ideal closure of the pancreatic remnant is still to be developed, as none of the widespread techniques (hand-sewn suture or staple closure) proved to be statistically significantly superior. Additional closure and covering methods (seromuscular patch, falciform ligament patch, pancreatico-enteric anastomosis, reinforced staplers, fibrin glue etc.) can have profitable effect but strong evidences are yet to come due to small case numbers. The recent introduction of standardized classification of PFs and future prospective randomized trials are more likely to be susceptible to determine if any of the standard or experimental closure techniques is more beneficial than the others.

show abstract

Section: Coverage Of the Pancreatic Remnantmentioning

confidence: 99%

A Review of Techniques for Closure of the Pancreatic Remnant following Distal Pancreatectomy

et al. 2016

View full text Add to dashboard Cite

show abstract

“…1 -6 Numerous mitigation strategies have been proposed to reduce the incidence and effects of POPF, including the use of anastomotic stents, 7 -11 prophylactic somatostatin analogues, 12 -17 tissue sealants, 18 -21 and autologous tissue patches. 22,23 Routine placement of intraperitoneal drains following PD is another common approach 24,25 ; however, their perceived clinical benefit has been contested in several major studies. 25 -32 A randomized study by Conlon et al showed that drains were associated with higher rates of fistula, and it was postulated that drains are unnecessary and may even be harmful to the patient.…”

Section: Introductionmentioning

confidence: 99%

The Value of Drains as a Fistula Mitigation Strategy for Pancreatoduodenectomy: Something for Everyone? Results of a Randomized Prospective Multi-institutional Study

McMillan

Fisher

Buren

et al. 2015

Journal of Gastrointestinal Surgery

View full text Add to dashboard Cite

show abstract

“…Postoperative pancreatic fistula (POPF) is the most common major complication after PD [2,3]. It is a potentially serious and life-threatening event, which may lead to prolonged hospital stay and increased costs [3,5,6]. There is a high variability on the reported rates of POPF, ranging from 2% to more than 20% [2,4].…”

Section: Introductionmentioning

confidence: 99%

A grading system can predict clinical and economic outcomes of pancreatic fistula after pancreaticoduodenectomy: results in 755 consecutive patients

Daskalaki

Butturini

Molinari

et al. 2010

Langenbecks Arch Surg

View full text Add to dashboard Cite

show abstract

Use of the Round Ligament of the Liver to Decrease Pancreatic Fistulas: A Novel Technique

Cited by 74 publications

References 24 publications

A Review of Techniques for Closure of the Pancreatic Remnant following Distal Pancreatectomy

A Review of Techniques for Closure of the Pancreatic Remnant following Distal Pancreatectomy

The Value of Drains as a Fistula Mitigation Strategy for Pancreatoduodenectomy: Something for Everyone? Results of a Randomized Prospective Multi-institutional Study

A grading system can predict clinical and economic outcomes of pancreatic fistula after pancreaticoduodenectomy: results in 755 consecutive patients

Contact Info

Product

Resources

About