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Wrapping the pancreas with a polyglycolic acid sheet before stapling reduces the risk of fluid collection on the pancreatic stump after distal pancreatectomy

Authors
 Ji Su Kim  ;  Seoung Yoon Rho  ;  Dong Min Shin  ;  Munseok Choi  ;  Chang Moo Kang  ;  Woo Jung Lee  ;  Ho Kyoung Hwang 
Citation
 SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, Vol.36(2) : 1191-1198, 2022-02 
Journal Title
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES
ISSN
 0930-2794 
Issue Date
2022-02
MeSH
Humans ; Pancreas / surgery ; Pancreatectomy* / adverse effects ; Pancreatectomy* / methods ; Pancreatic Fistula / epidemiology ; Pancreatic Fistula / etiology ; Pancreatic Fistula / prevention & control ; Polyglycolic Acid* / therapeutic use ; Postoperative Complications / epidemiology ; Postoperative Complications / etiology ; Postoperative Complications / prevention & control ; Retrospective Studies ; Risk Factors ; Surgical Stapling / adverse effects
Keywords
Distal pancreatectomy ; Fluid collection ; Pancreatic fistula ; Polyglycolic acid ; Stapling
Abstract
Background: Postoperative pancreatic fistula (POPF) and postoperative fluid collection (POFC) are common complications after distal pancreatectomy (DP). The previous method of reducing the risk of POPF was the application of a polyglycolic acid (PGA) sheet to the pancreatic stump after cutting the pancreas with a stapler (After-stapling); the new method involves wrapping the pancreatic resection line with a PGA sheet before stapling (Before-stapling). The study aimed to compare the incidence of POPF and POFC between two methods.

Methods: Data of patients who underwent open or laparoscopic DPs by a single surgeon from October 2010 to February 2020 in a tertiary referral hospital were retrospectively analyzed. POPF was defined according to the updated International Study Group of Pancreatic Fistula criteria. POFC was measured by postoperative computed tomography (CT).

Results: Altogether, 182 patients were enrolled (After-stapling group, n = 138; Before-stapling group, n = 44). Clinicopathologic and intraoperative findings between the two groups were similar. Clinically relevant POPF rates were similar between both groups (4.3% vs. 4.5%, p = 0.989). POFC was significantly lesser in the Before-stapling group on postoperative day 7 (p < 0.001).

Conclusions: Wrapping the pancreas with PGA sheet before stapling was a simple and effective way to reduce POFC.
DOI
10.1007/s00464-021-08387-0
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Chang Moo(강창무) ORCID logo https://orcid.org/0000-0002-5382-4658
Kim, Ji Su(김지수) ORCID logo https://orcid.org/0000-0002-9501-9665
Rho, Seoung Yoon(노승윤) ORCID logo https://orcid.org/0000-0002-1265-826X
Lee, Woo Jung(이우정) ORCID logo https://orcid.org/0000-0001-9273-261X
Choi, Munseok(최문석) ORCID logo https://orcid.org/0000-0002-9844-4747
Hwang, Ho Kyoung(황호경) ORCID logo https://orcid.org/0000-0003-4064-7776
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/187868
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