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

Abstract

BACKGROUND/AIM:

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.

PATIENTS AND METHODS:

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.

RESULTS:

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/m2 (p=0.038).

CONCLUSION:

Reinforced triple-row staplers may reduce the incidence of severe POPF, especially in obese patients with a BMI >25 kg/m2.

• Authors: Hiromichi Kawaida, Hiroshi Kono, Hidetake Amemiya, Naohiro Hosomura, Ryo Saito, Kazunori Takahashi, Atsushi Yamamoto, Mitsuaki Watanabe, Shinji Furuya, Hiroki Shimizu, Hidenori Akaike, Yoshihiko Kawaguchi, Makoto Sudo, Masanori Matusda, Jun Itakura, Hideki Fujii, Daisuke Ichikawa
• Journal: Anticancer research (Anticancer Res) Vol. 39 Issue 2 Pg. 1013-1018 (Feb 2019) ISSN: 1791-7530 [Electronic] Greece
• PMID: 30711989 (Publication Type: Journal Article)
• Copyright: Copyright© 2019, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

Topics

• Aged
• Body Mass Index
• Female
• Humans
• Incidence
• Male
• Middle Aged
• Obesity (complications, surgery)
• Pancreatectomy (adverse effects, instrumentation, methods)
• Pancreatic Fistula (etiology, prevention & control)
• Postoperative Complications (etiology, prevention & control)
• Prospective Studies
• Risk Factors
• Surgical Staplers
• Surgical Stapling (adverse effects, instrumentation)