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Retroperitonealization of the pancreatic stump in distal pancreatectomy: a novel technique to reduce postoperative pancreatic fistula

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Abstract

Purpose

To evaluate the efficacy and safety of retroperitonealization of the pancreatic stump in distal pancreatectomy.

Methods

Clinical data from the Tongji Hospital pancreatic database were retrospectively reviewed in this study. The data of 68 patients who underwent retroperitonealized distal pancreatectomy from January, 2019, to April, 2021, were collected and analyzed. Sixty-four patients who underwent conventional distal pancreatectomy during the same period were matched. We compared and analyzed the operative outcomes and postoperative complications between the patients in the two groups before and after propensity score matching (PSM).

Results

Before PSM, the operative outcomes and postoperative complications were comparable between the two groups. After PSM, the retroperitonealized group had a lower incidence of postoperative pancreatic fistula (POPF) (10.53% vs 31.58%, P = 0.047) and shorter time until drainage removal (10.00, 8.00–13.00 days vs 13.00, 10.00–18.00 days, P = 0.005). In the univariate and multivariate regression analyses, non-retroperitonealization and intra-abdominal infection were found to be independent risk factors for postoperative pancreatic fistula (POPF).

Conclusion

Retroperitonealization of the pancreatic stump can reduce the incidence of POPF after distal pancreatectomy.

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Data Availability

All the data and codes for statistical analysis in this study are available from RQ at ryqin@tjh.tjmu.edu.cn, and the data requestors will need to sign a data access agreement.

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Acknowledgements

We thank Angela Morben, DVM, ELS, from Liwen Bianji, Edanz Editing China (www.liwenbianji.cn/ac), for editing the English text of a draft of this manuscript.

Funding

This study was supported by grants from The National Natural Science Foundation of China (81772950 to RY Q and 81773160 to MW), Hubei Natural Science Foundation (2017CFB467) to MW, and Tongji Hospital Clinical Research Flagship Program (2019CR203) to RY Q.

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Author notes

  1. Ruizhi He and Renyi Qin contributed equally to this work.

Authors and Affiliations

  1. Department of Biliary-Pancreatic Surgery, Affiliated Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Ave, Wuhan, 430030, Hubei, China

    Taoyuan Yin, Jingxiong Yuan, Yi Wu, Shizhen Li, Min Wang, Ruizhi He & Renyi Qin

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  1. Taoyuan Yin
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  2. Jingxiong Yuan
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Contributions

Taoyuan Yin Analysis and interpretation of data, Drafting of manuscript Jingxiong Yuan Acquisition of data, Drafting of manuscript Yi WuAcquisition of data Shizhen Li Acquisition of data Min WangStudy conception and design, Critical revision of manuscript Ruizhi He Analysis and interpretation of data, Critical revision of manuscript Renyi Qin Study conception and design, Critical revision of manuscript

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Correspondence to Ruizhi He or Renyi Qin.

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Yin, T., Yuan, J., Wu, Y. et al. Retroperitonealization of the pancreatic stump in distal pancreatectomy: a novel technique to reduce postoperative pancreatic fistula. Langenbecks Arch Surg 408, 425 (2023). https://doi.org/10.1007/s00423-023-03138-2

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