The influence of transection site on the development of pancreatic fistula in patients undergoing distal pancreatectomy: A review of 294 consecutive cases

Surgery
Naomi M SellHarish Lavu

Abstract

Pancreatic fistula (PF) is a significant cause of morbidity in patients undergoing distal pancreatectomy (DP), with an incidence of 15-40%. It remains unclear if the location of pancreatic transection affects the rate of PF occurrence. This study examines the correlation between the transection site of the pancreas during DP and the incidence of PF. All cases of DP from October 2005 to January 2012 were reviewed retrospectively from an institutional review board-approved database at the Thomas Jefferson University Hospital. Patient demographics and perioperative outcomes were analyzed. The pancreatic transection location was determined by review of operative reports, and then dichotomized into 2 groups: neck/body or tail. PF were graded following the International Study Group on Pancreatic Fistula guidelines. During the study period, 294 DP were performed with 244 pancreas transections at the neck/body and 50 at the tail. Of the 294 patients, 52 (17.7%) developed a postoperative PF. The incidence of PF after transection at the tail of the pancreas was higher (28%) when compared with transection at the neck/body (15.6%; P = .04). When stratified by PF grade, grade A PF occurred more commonly when transection of the gland was at ...Continue Reading

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Citations

Dec 3, 2015·Pancreatology : Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]·Mingjun WangWeiming Hu
May 25, 2016·Scandinavian Journal of Gastroenterology·Kjetil Søreide, Knut Jørgen Labori
Jun 22, 2016·Surgery Today·Yoshihiro MiyasakaMasafumi Nakamura
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Oct 16, 2016·Annals of Surgery·Thijs de RooijUNKNOWN Dutch Pancreatic Cancer Group
Aug 30, 2020·Journal of Clinical Medicine·Ki Byung SongSong Cheol Kim
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Mar 27, 2021·Pancreatology : Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]·Javier A CienfuegosFernando Rotellar

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