Closure method for thick pancreas stump after distal pancreatectomy: soft coagulation and polyglycolic acid felt with fibrin glue

Langenbeck's Archives of Surgery
Hirofumi AkitaOsamu Ishikawa

Abstract

Pancreatic fistula (PF) remains an obstacle to safe distal pancreatectomy (DP). A thick pancreatic parenchyma is a major risk factor for PF. In this paper, we elucidate the feasibility of the new closure method using soft coagulation and polyglycolic acid felt with fibrin glue. In 2009-2013, 96 patients underwent DP with a novel closure method for pancreatic stump that utilized soft coagulation and polyglycolic acid felt with fibrin glue. We evaluated amylase levels in drainage fluid on postoperative days (POD) 1 and 3 and the incidence of postoperative PF according to International Study Group of Pancreatic Fistula (ISGPF) definitions. Drain amylase levels on POD1 and POD3 were 275 and 241 U/L, respectively, and ISGPF-defined Grade B/C PF rates were 16.7%. No clinical factors were significantly associated with PF. Average pancreatic parenchymal thicknesses were similar in PF-positive and PF-negative patients (10.4 ± 2.6 mm vs. 10.1 ± 2.2 mm, P = 0.639). There was no significant difference in the postoperative PF rate between patients with thick (≥12 mm) and thin (<12 mm) pancreas (11.1 vs. 18.8%, P = 0.544). Our novel pancreatic stump closure method appears to be simple and effective, particularly in patients with thick pancreas.

References

Dec 1, 1996·The British Journal of Surgery·Y KajiyamaH Akiyama
May 2, 1998·World Journal of Surgery·S OhwadaY Morishita
Apr 12, 2002·American Journal of Surgery·Bridget N FahyRichard J Bold
Jul 2, 2003·The Japanese Journal of Thoracic and Cardiovascular Surgery : Official Publication of the Japanese Association for Thoracic Surgery = Nihon Kyōbu Geka Gakkai Zasshi·Hideaki MiyamotoEnjo Hata
Jun 30, 2005·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Gianpaolo BalzanoValerio Di Carlo
Jul 9, 2005·Surgery·Claudio BassiUNKNOWN International Study Group on Pancreatic Fistula Definition
Jun 22, 2006·Journal of Surgical Oncology·Akira HayashibeTakeshi Nakamoto
Apr 7, 2007·Annals of Surgery·Jörg KleeffMarkus W Büchler
Apr 27, 2007·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·M WagnerD Candinas
Sep 19, 2007·World Journal of Gastroenterology : WJG·Marco Pericoli RidolfiniGiovanni Battista Doglietto
Dec 12, 2007·American Journal of Surgery·Takeyuki MisawaKatsuhiko Yanaga
Feb 5, 2008·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Hideki Itano
Jun 7, 2008·Journal of Hepato-biliary-pancreatic Surgery·Giovanni ButturiniClaudio Bassi
Aug 2, 2008·Journal of Hepato-biliary-pancreatic Surgery·Keiichi OkanoYasuyuki Suzuki
Aug 2, 2008·Journal of Hepato-biliary-pancreatic Surgery·Yuichi NagakawaTatsuya Aoki
Aug 16, 2008·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Cristina R FerroneCarlos Fernandez-del Castillo
Jul 30, 2009·Annals of Surgery·Hari NathanMichael A Choti
Mar 10, 2011·World Journal of Surgery·Matthias ReehMaximilian Bockhorn
Oct 22, 2011·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Boris SepesiLuke O Schoeniger
Dec 22, 2011·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Joseph A BlansfieldMohsen M Shabahang
Feb 23, 2013·Journal of Hepato-biliary-pancreatic Sciences·Motokazu SugimotoHironori Kaneko
Apr 26, 2013·European Surgical Research. Europäische Chirurgische Forschung. Recherches Chirurgicales Européennes·Y KawabataY Tajima

❮ Previous
Next ❯

Citations

Apr 24, 2021·International Journal of Gynecological Cancer : Official Journal of the International Gynecological Cancer Society·Ayumu MatsuokaMakio Shozu
Jun 9, 2021·Langenbeck's Archives of Surgery·Manabu MikamoriHidetoshi Eguchi

❮ Previous
Next ❯

Related Concepts

Related Feeds

Blood Clotting Disorders

Thrombophilia includes conditions with increased tendency for excessive blood clotting. Blood clotting occurs when the body has insufficient amounts of specialized proteins that make blood clot and stop bleeding. Here is the latest research on blood clotting disorders.