Efficacy of Pancreatic Dissection With a Triple-row Stapler in Laparoscopic Distal Pancreatectomy: A Retrospective Observational Study.

IF 1.1 4区医学 Q3 SURGERY Surgical Laparoscopy, Endoscopy & Percutaneous Techniques Pub Date : 2024-06-01 DOI:10.1097/SLE.0000000000001284

Hideki Izumi, Hisamichi Yoshii, Rika Fujino, Shigeya Takeo, Eiji Nomura, Masaya Mukai, Hiroyasu Makuuchi

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Abstract

Background: Postoperative pancreatic fistulas (POPFs) occur after 20% to 30% of laparoscopic distal pancreatectomies. This study aimed to evaluate the clinical efficacy of laparoscopic distal pancreatectomy using triple-row staplers in preventing POPFs.

Methods: Between April 2016 and May 2023, 59 patients underwent complete laparoscopic distal pancreatectomies. There were more females (n=34, 57.6%) than males (n=25, 42.4%). The median age of the patients was 68.9 years. The patients were divided into slow-compression (n=19) and no-compression (n=40) groups and examined for pancreatic leakage. Both groups were examined with respect to age, sex, body mass index (BMI), pancreatic thickness at the pancreatic dissection site, pancreatic texture, diagnosis, operative time, blood loss, presence of POPF, date of drain removal, and length of hospital stay. In addition, risk factors for POPF were examined in a multivariate analysis.

Results: Grade B POPFs were found in 9 patients (15.3%). Using univariate analysis, the operative time, blood loss, postoperative pancreatic fluid leakage, day of drain removal, and hospital stay were shorter in the no-compression group than in the slow-compression group. Using multivariate analysis, the absence of POPFs was significantly more frequent in the no-compression group (odds ratio, 5.69; 95% CI, 1.241-26.109; P =0.025). The no-compression pancreatic dissection method was a simple method for reducing POPF incidence.

Conclusions: The method of quickly dissecting the pancreas without compression yielded better results than the method of slowly dissecting the pancreas with slow compression. This quick dissection without compression was a simple and safe method that minimized postoperative pancreatic fluid leakage, shortened the operative time and length of hospital stay, and reduced medical costs. Therefore, this method might be a clinically successful option.

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腹腔镜胰腺远端切除术中使用三排缝合器进行胰腺分割的效果：回顾性观察研究

背景：20%至30%的腹腔镜胰腺远端切除术后会出现术后胰瘘（POPFs）。本研究旨在评估使用三排订书机的腹腔镜胰腺远端切除术在预防 POPFs 方面的临床疗效：2016年4月至2023年5月期间，59名患者接受了完整的腹腔镜胰腺远端切除术。其中女性（34 人，57.6%）多于男性（25 人，42.4%）。患者的中位年龄为 68.9 岁。患者被分为慢压迫组（19 人）和无压迫组（40 人），并对胰腺渗漏情况进行了检查。对两组患者的年龄、性别、体重指数（BMI）、胰腺解剖部位的胰腺厚度、胰腺纹理、诊断、手术时间、失血量、是否存在 POPF、引流管拔除日期和住院时间进行了检查。此外，还对POPF的风险因素进行了多变量分析：结果：9 名患者（15.3%）出现了 B 级 POPF。通过单变量分析，不加压组的手术时间、失血量、术后胰液渗漏、引流管拔除天数和住院时间均短于缓慢加压组。通过多变量分析，不加压组出现 POPFs 的频率明显更高（几率比，5.69；95% CI，1.241-26.109；P=0.025）。无压迫胰腺解剖法是降低 POPF 发生率的一种简单方法：结论：不加压快速解剖胰腺的方法比加压缓慢解剖胰腺的方法效果更好。这种不加压快速解剖胰腺的方法简单安全，能最大限度地减少术后胰液渗漏，缩短手术时间和住院时间，降低医疗费用。因此，这种方法在临床上可能是一种成功的选择。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Surgical Laparoscopy, Endoscopy & Percutaneous Techniques 医学-外科

CiteScore

2.00

自引率

10.00%

发文量

103

审稿时长

3-8 weeks

期刊介绍： Surgical Laparoscopy Endoscopy & Percutaneous Techniques is a primary source for peer-reviewed, original articles on the newest techniques and applications in operative laparoscopy and endoscopy. Its Editorial Board includes many of the surgeons who pioneered the use of these revolutionary techniques. The journal provides complete, timely, accurate, practical coverage of laparoscopic and endoscopic techniques and procedures; current clinical and basic science research; preoperative and postoperative patient management; complications in laparoscopic and endoscopic surgery; and new developments in instrumentation and technology.