Skip to main content

Advertisement

SpringerLink
Log in

Prolonged peri-firing compression with a linear stapler prevents pancreatic fistula in laparoscopic distal pancreatectomy

  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Background

Laparoscopic distal pancreatectomy (Lap-DP) is one of the most accepted laparoscopic procedures in the field of pancreatic surgery. However, pancreatic fistula remains a major and frequent complication in Lap-DP, as in open surgery. The aim of this retrospective study is to clarify the advantages of prolonged peri-firing compression (PFC) with a linear stapler for prevention of pancreatic fistula after laparoscopic distal pancreatectomy.

Patients and methods

Incidence of pancreatic fistula in clinical levels (equivalent to grades B and C defined by the International Study Group of Pancreatic Fistula (ISGPF)) was retrospectively compared between patients who underwent Lap-DP with PFC (PFC group, n = 17) and those who underwent Lap-DP without PFC (no-PFC group, n = 25).

Results

Incidence of clinical pancreatic fistula was significantly lower in the PFC group than in the no-PFC group. Consistent with the results for pancreatic fistula, peritoneal drainage period and postoperative hospital stay were shorter in the PFC group than in the no-PFC group.

Conclusions

Our data show that PFC effectively prevents pancreatic fistula and shortens postoperative hospital stay after Lap-DP.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Tanaka M, Shimizu S, Mizumoto K, Yokohata K, Chijiiwa K, Yamaguchi K, Ogawa Y (2001) Laparoscopically assisted resection of choledochal cyst and Roux-en-Y reconstruction. Surg Endosc 15(6):545–552

    Article  PubMed  CAS  Google Scholar 

  2. Ogawa T, Shimizu S, Mizumoto K, Uchiyama A, Yokohata K, Chijiiwa K, Tanaka M (2001) Comparison of laparoscopic versus open cholecystectomy in patients with cardiac valve replacement. J Hepatobiliary Pancreat Surg 8(2):158–160

    Article  PubMed  CAS  Google Scholar 

  3. Shimizu S, Yokohata K, Mizumoto K, Yamaguchi K, Chijiiwa K, Tanaka M (2002) Laparoscopic choledochotomy for bile duct stones. J Hepatobiliary Pancreat Surg 9(2):201–205

    Article  PubMed  Google Scholar 

  4. Noshiro H, Shimizu S, Nagai E, Ohuchida K, Tanaka M (2003) Laparoscopy-assisted distal gastrectomy for early gastric cancer: is it beneficial for patients of heavier weight? Ann Surg 238(5):680–685

    Article  PubMed  Google Scholar 

  5. Shimizu S, Nakashima N, Okamura K, Hahm JS, Kim YW, Moon BI, Han HS, Tanaka M (2006) International transmission of uncompressed endoscopic surgery images via superfast broadband Internet connections. Surg Endosc 20(1):167–170

    Article  PubMed  CAS  Google Scholar 

  6. Kim SC, Park KT, Hwang JW, Shin HC, Lee SS, Seo DW, Lee SK, Kim MH, Han DJ (2008) Comparative analysis of clinical outcomes for laparoscopic distal pancreatic resection and open distal pancreatic resection at a single institution. Surg Endosc 22(10):2261–2268

    Article  PubMed  Google Scholar 

  7. Misawa T, Shiba H, Usuba T, Nojiri T, Uwagawa T, Ishida Y, Ishii Y, Yanaga K (2008) Safe and quick distal pancreatectomy using a staggered six-row stapler. Am J Surg 195(1):115–118

    Article  PubMed  Google Scholar 

  8. Sheehan MK, Beck K, Creech S, Pickleman J, Aranha GV (2002) Distal pancreatectomy: does the method of closure influence fistula formation? Am Surg 68(3):264–267 discussion 267–268

    PubMed  Google Scholar 

  9. Knaebel HP, Diener MK, Wente MN, Buchler MW, Seiler CM (2005) Systematic review and meta-analysis of technique for closure of the pancreatic remnant after distal pancreatectomy. Br J Surg 92(5):539–546

    Article  PubMed  CAS  Google Scholar 

  10. Shimizu S, Tanaka M, Konomi H, Mizumoto K, Yamaguchi K (2004) Laparoscopic pancreatic surgery: current indications and surgical results. Surg Endosc 18(3):402–406

    Article  PubMed  CAS  Google Scholar 

  11. Shimizu S, Tanaka M, Konomi H, Tamura T, Mizumoto K, Yamaguchi K (2004) Spleen-preserving laparoscopic distal pancreatectomy after division of the splenic vessels. J Laparoendosc Adv Surg Tech A 14(3):173–177

    Article  PubMed  Google Scholar 

  12. Warshaw AL (1988) Conservation of the spleen with distal pancreatectomy. Arch Surg 123(5):550–553

    PubMed  CAS  Google Scholar 

  13. Pratt WB, Maithel SK, Vanounou T, Huang ZS, Callery MP, Vollmer CM Jr (2007) Clinical and economic validation of the International Study Group of Pancreatic Fistula (ISGPF) classification scheme. Ann Surg 245(3):443–451

    Article  PubMed  Google Scholar 

  14. Bassi C, Dervenis C, Butturini G, Fingerhut A, Yeo C, Izbicki J, Neoptolemos J, Sarr M, Traverso W, Buchler M (2005) Postoperative pancreatic fistula: an international study group (ISGPF) definition. Surgery 138(1):8–13

    Article  PubMed  Google Scholar 

  15. Yamaguchi K, Chijiwa K, Shimizu S, Yokohata K, Tanaka M (1998) Litmus paper helps detect potential pancreatoenterostomy leakage. Am J Surg 175(3):227–228

    Article  PubMed  CAS  Google Scholar 

  16. Sugiyama M, Abe N, Izumisato Y, Tokuhara M, Masaki T, Mori T, Atomi Y (2001) Pancreatic transection using ultrasonic dissector in pancreatoduodenectomy. Am J Surg 182(3):257–259

    Article  PubMed  CAS  Google Scholar 

  17. Pachter HL, Pennington R, Chassin J, Spencer FC (1979) Simplified distal pancreatectomy with the Auto Suture stapler: preliminary clinical observations. Surgery 85(2):166–170

    PubMed  CAS  Google Scholar 

  18. Kajiyama Y, Tsurumaru M, Udagawa H, Tsutsumi K, Kinoshita Y, Akiyama H (1996) Quick and simple distal pancreatectomy using the GIA stapler: report of 35 cases. Br J Surg 83(12):1711

    Article  PubMed  CAS  Google Scholar 

  19. Takeuchi K, Tsuzuki Y, Ando T, Sekihara M, Hara T, Kori T, Nakajima H, Kuwano H (2003) Distal pancreatectomy: is staple closure beneficial? ANZ J Surg 73(11):922–925

    Article  PubMed  Google Scholar 

  20. Palanivelu C, Shetty R, Jani K, Sendhilkumar K, Rajan PS, Maheshkumar GS (2007) Laparoscopic distal pancreatectomy: results of a prospective non-randomized study from a tertiary center. Surg Endosc 21(3):373–377

    Article  PubMed  CAS  Google Scholar 

  21. Kuroki T, Tajima Y, Kanematsu T (2005) Surgical management for the prevention of pancreatic fistula following distal pancreatectomy. J Hepatobiliary Pancreat Surg 12(4):283–285

    Article  PubMed  Google Scholar 

  22. Okano K, Kakinoki K, Yachida S, Izuishi K, Wakabayashi H, Suzuki Y (2008) A simple and safe pancreas transection using a stapling device for a distal pancreatectomy. J Hepatobiliary Pancreat Surg 15(4):353–358

    Article  PubMed  Google Scholar 

  23. Morita K, Tokunou K, Hiraki S, Kudo A, Fukuda S, Masaaki O (2006) The effects of waiting time after clamp of a linear automatic stapling instrument in small bowel resection of a pig. JSES 11(4):461–463

    Google Scholar 

Download references

Disclosures

Authors M. Nakamura, J. Ueda, H. Kohno, M.Y.F. Aly, S. Takahata, S. Shimizu, and M. Tanaka have no conflicts of interest or financial ties to disclose.

Author information

Authors and Affiliations

  1. Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

    Masafumi Nakamura, Junji Ueda, Hiroshi Kohno, Mohamed Yahia F. Aly, Shunichi Takahata, Shuji Shimizu & Masao Tanaka

Authors
  1. Masafumi Nakamura
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Junji Ueda
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hiroshi Kohno
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mohamed Yahia F. Aly
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Shunichi Takahata
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Shuji Shimizu
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Masao Tanaka
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Masafumi Nakamura.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Nakamura, M., Ueda, J., Kohno, H. et al. Prolonged peri-firing compression with a linear stapler prevents pancreatic fistula in laparoscopic distal pancreatectomy. Surg Endosc 25, 867–871 (2011). https://doi.org/10.1007/s00464-010-1285-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-010-1285-6

Keywords

Search

Navigation