Polyester sutures for pancreaticojejunostomy protect against postoperative pancreatic fistula: a case-control, risk-adjusted analysis

HPB : the Official Journal of the International Hepato Pancreato Biliary Association
Stefano AndrianelloClaudio Bassi

Abstract

There is wide variability in the use of suture material for pancreatic anastomosis after pancreaticoduodenectomy (PD). This study evaluates the role of suture material on clinically relevant postoperative pancreatic fistula (CR-POPF) after pancreaticojejunostomy (PJ) in a risk-adjusted setting. A retrospective study comparing (polyester) PE with polydioxanone (PDO) in 520 PDs. Patients were matched for risk for CR-POPF according to the fistula risk score (FRS) with the propensity score. The matched PE and PDO groups consisted of 232 patients. The incidence of CR-POPF was lower for PE group (11.6 vs. 22%, p<0.01), with a lower rate of grade B (10.3 vs. 15.5%, p<0.01) and C (1.3 vs. 6.5%, p<0.01). After stratifying by fistula risk zone, PE suture remained associated with a reduced incidence of CR-POPF (9.4 vs. 15.6% low-, p = 0.04; 15.6 vs. 28.1% intermediate-, p = 0.02; 16.7 vs. 83.3% high-risk zone, p<0.01, respectively). Multivariable analysis demonstrated that pancreatic texture, preoperative diagnosis, FRS and the use of PE sutures were independent predictors of CR-POPF. In the setting of a case-control matched for risk analysis, the use of PE suture for PJ is associated with a significant reduction of CR-POPF.

References

Jul 14, 2004·American Journal of Surgery·M A Tolga MuftuogluAbdullah Saglam
Jul 9, 2005·Surgery·Claudio BassiUNKNOWN International Study Group on Pancreatic Fistula Definition
Oct 13, 2007·The British Journal of Surgery·G BalzanoV Di Carlo
Mar 4, 2011·Annals of Surgery·Patrick PessauxUNKNOWN Fédération de Recherche en Chirurgie (French)
Jun 3, 2011·The New England Journal of Medicine·Jonathan F FinksJohn D Birkmeyer
Nov 6, 2012·Journal of the American College of Surgeons·Mark P CalleryCharles M Vollmer
Mar 6, 2013·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Ian Martin, Kenneth Au
May 15, 2013·The Journal of Surgical Research·Orlin BelyaevWaldemar Uhl
Jun 26, 2013·Nature Reviews. Gastroenterology & Hepatology·Giuseppe Malleo, Claudio Bassi
Sep 5, 2013·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Benjamin C MillerCharles M Vollmer
Apr 16, 2014·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Tsutomu FujiiYasuhiro Kodera
May 23, 2014·The New England Journal of Medicine·Peter J AllenWilliam R Jarnagin
Aug 19, 2015·Journal of the American College of Surgeons·Matthew T McMillanCharles M Vollmer
Sep 17, 2015·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Matthew T McMillanCharles M Vollmer
Dec 30, 2015·Pancreatology : Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]·Stefano AndrianelloClaudio Bassi
Oct 13, 2016·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Matthew T McMillanCharles M Vollmer
Oct 27, 2016·Journal of Investigative Surgery : the Official Journal of the Academy of Surgical Research·Kerem KaramanMusa Akoglu
Sep 2, 2017·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Stefano AndrianelloClaudio Bassi

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Citations

Jul 10, 2019·Expert Review of Gastroenterology & Hepatology·Yien XiangXuewen Zhang
Jun 23, 2020·Expert Review of Gastroenterology & Hepatology·Jiacheng WuXuewen Zhang
Oct 2, 2020·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Chien-Hui WuYu-Wen Tien
Nov 11, 2019·International Journal of Surgery·Mathieu VandeputteFranky Vansteenkiste

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