Retrospective Analysis of the Effect of Hand-sewn and Stapler Closure of Pancreatic Stump After Distal Pancreatectomy on the Development of Postoperative Pancreatic Fistula

Gülten Çiçek Okuyan

Article Details

Retrospective Analysis of the Effect of Hand-sewn and Stapler Closure of Pancreatic Stump After Distal Pancreatectomy on the Development of Postoperative Pancreatic Fistula

Authors:

Gülten Çiçek Okuyan

Publisher:

Duzce University

Main Topics:

Klinik Tıp Bilimleri

Journal:

Sağlık Bilimlerinde Değer Vol.13 Issue 1, pp.99-107

Document Type:

Article

Publication Date:

1/2023

Document Language:

English

Document ID (Org No.):

2001281923

pISSN:

2792-0542

Keywords:

Abstract:

 Aim: Hand-sewn HS and stapled closure ST of pancreatic stump following distal pancreatectomy are two frequently used techniques. Rates of postoperative pancreatic fistula POPF might be associated with stump closure techniques. This study was carried out to determine rates of POPF after distal pancreatectomy and evaluate impact of two closure methods on development of POPF. Material and Methods: All patients who underwent elective open or laparoscopic distal pancreatectomy for malignant and benign pancreatic pathologies between 2011 and 2021 were retrospectively evaluated. Patients were grouped as Groups HS and ST. POPF was diagnosed and graded according to International Study Group of Pancreatic Fistula guidelines. Rates of biochemical leak and grades of POPF were primary outcome. Results: There were 44 patients 28 in Group HS and 16 in Group ST with a mean age of 51.815.1 years. Groups were similar in demographic and clinical characteristics p0.05. There were 15 patients 53.6 with a biochemical leak in Group HS. In Group ST, six patients 37.5 developed biochemical leaks. There was no significant in difference between groups in terms of biochemical leak p0.305. No patient in Group ST developed a pancreatic fistula. There was only one case with Grade B POPF in Group HS. We did not detect a significant difference in terms of POPF between groups p0.999. Conclusion: Both techniques had no significant impact on biochemical leak and POPF rates in patients who underwent distal pancreatectomy. Both pancreatic stump closure approaches are equally safe and can be used with similar clinical efficacy.

 Aim: Hand-sewn HS and stapled closure ST of pancreatic stump following distal pancreatectomy are two frequently used techniques. Rates of postoperative pancreatic fistula POPF might be associated with stump closure techniques. This study was carried out to determine rates of POPF after distal pancreatectomy and evaluate impact of two closure methods on development of POPF. Material and Methods: All patients who underwent elective open or laparoscopic distal pancreatectomy for malignant and benign pancreatic pathologies between 2011 and 2021 were retrospectively evaluated. Patients were grouped as Groups HS and ST. POPF was diagnosed and graded according to International Study Group of Pancreatic Fistula guidelines. Rates of biochemical leak and grades of POPF were primary outcome. Results: There were 44 patients 28 in Group HS and 16 in Group ST with a mean age of 51.815.1 years. Groups were similar in demographic and clinical characteristics p0.05. There were 15 patients 53.6 with a biochemical leak in Group HS. In Group ST, six patients 37.5 developed biochemical leaks. There was no significant in difference between groups in terms of biochemical leak p0.305. No patient in Group ST developed a pancreatic fistula. There was only one case with Grade B POPF in Group HS. We did not detect a significant difference in terms of POPF between groups p0.999. Conclusion: Both techniques had no significant impact on biochemical leak and POPF rates in patients who underwent distal pancreatectomy. Both pancreatic stump closure approaches are equally safe and can be used with similar clinical efficacy.

 Aim: Hand-sewn HS and stapled closure ST of pancreatic stump following distal pancreatectomy are two frequently used techniques. Rates of postoperative pancreatic fistula POPF might be associated with stump closure techniques. This study was carried out to determine rates of POPF after distal pancreatectomy and evaluate impact of two closure methods on development of POPF. Material and Methods: All patients who underwent elective open or laparoscopic distal pancreatectomy for malignant and benign pancreatic pathologies between 2011 and 2021 were retrospectively evaluated. Patients were grouped as Groups HS and ST. POPF was diagnosed and graded according to International Study Group of Pancreatic Fistula guidelines. Rates of biochemical leak and grades of POPF were primary outcome. Results: There were 44 patients 28 in Group HS and 16 in Group ST with a mean age of 51.815.1 years. Groups were similar in demographic and clinical characteristics p0.05. There were 15 patients 53.6 with a biochemical leak in Group HS. In Group ST, six patients 37.5 developed biochemical leaks. There was no significant in difference between groups in terms of biochemical leak p0.305. No patient in Group ST developed a pancreatic fistula. There was only one case with Grade B POPF in Group HS. We did not detect a significant difference in terms of POPF between groups p0.999. Conclusion: Both techniques had no significant impact on biochemical leak and POPF rates in patients who underwent distal pancreatectomy. Both pancreatic stump closure approaches are equally safe and can be used with similar clinical efficacy.

 Amaç: Distal pankreatektomiyi takiben pankreatik güdüğünün manuel dikiş ve stapler yardımıyla kapatılması sık kullanılan iki tekniktir. Postoperatif pankreatik fistül oranları güdük kapama teknikleri ile ilişkili olabilir. Bu çalışma, distal pankreatektomi sonrası pankreatik fistül oranlarını belirlemek ve iki kapama yönteminin pankreas fistülü gelişimine etkisini değerlendirmek amacıyla yapıldı. Gereç ve Yöntemler: 2011-2021 yılları arasında malign ve benign pankreas patolojileri nedeniyle elektif açık veya laparoskopik distal pankreatektomi yapılan tüm hastalar retrospektif olarak değerlendirildi. Hastalar Grup HS manuel dikiş ile kapama ve Grup ST stapler yardımlı kapama olarak gruplandırıldı. Pankreas fistülü tanısı, Uluslararası Pankreas Fistülü Çalışma Grubu kılavuzlarına göre belirlendi ve derecelendirildi. Biyokimyasal kaçak oranları ve ameliyat sonrası pankreatik fistül dereceleri birincil sonuç olarak kabul edildi. Bulgular: Ortalama yaşı 51,8  15,1 yıl olan 44 hasta Grup HSde 28 ve Grup STde 16 vardı. Gruplar demografik ve klinik özellikler açısından benzerdi tüm p değerleri p0,05. Grup HSde biyokimyasal kaçağı olan 15 hasta, 53,6 vardı. Grup STde altı hastanın 37,5 biyokimyasal kaçağı olduğu tespit edildi. Gruplar arasındaki biyokimyasal kaçak gelişimi açısından anlamlı bir fark yoktu p0,305. Grup STde pankreas fistülü olan hasta yoktu. Buna karşın Grup HSde Grade B postoperatif pankreas fistülü olan sadece bir olgu vardı. Pankreas fistülü açısından gruplar arasında anlamlı bir fark tespit edilmedi p0,999. Sonuç: Distal pankreatektomi yapılan hastalarda manuel dikiş ile kapama veya stapler ile kapama tekniklerinin biyokimyasal kaçak ve postoperatif pankreatik fistül oranları üzerinde anlamlı bir etkisi olmadığı gösterildi. Dolayısıyla, her iki pankreas güdüğü kapama yaklaşımının eşit derecede güvenli olduğu ve benzer klinik etkinlikle ile kullanılabileceği sonucuna varılmıştır.

Article Details

Retrospective Analysis of the Effect of Hand-sewn and Stapler Closure of Pancreatic Stump After Distal Pancreatectomy on the Development of Postoperative Pancreatic Fistula

Authors:

Gülten Çiçek Okuyan

Publisher:

Duzce University

Main Topics:

Klinik Tıp Bilimleri

Journal:

Sağlık Bilimlerinde Değer Vol.13 Issue 1, pp.99-107

Document Type:

Article

Publication Date:

1/2023

Document Language:

English

Document ID (Org No.):

2001281923

pISSN:

2792-0542

Pancreatectomy

pancreatic fistula

suturing

surgical staplers

Pankreatektomi

pankreas fistülü

dikiş

cerrahi stapler

Issues

Article Details

Authors: Gülten Çiçek Okuyan

Publisher: Duzce University

Main Topics: Klinik Tıp Bilimleri

Journal: Sağlık Bilimlerinde Değer Vol.13 Issue 1, pp.99-107

Document Type: Article

Publication Date: 1/2023

Document Language: English

Document ID (Org No.): 2001281923

pISSN: 2792-0542

Issues

Authors:

Gülten Çiçek Okuyan

Publisher:

Duzce University

Main Topics:

Klinik Tıp Bilimleri

Journal:

Sağlık Bilimlerinde Değer Vol.13 Issue 1, pp.99-107

Document Type:

Article

Publication Date:

1/2023

Document Language:

English

Document ID (Org No.):

2001281923

pISSN:

2792-0542