BACKGROUND: Pancreatic fistula remains the primary source of morbidity following distal pancreatectomy. Previous studies have reported specific methods of parenchymal transection/stump sealing in an effort to decrease the pancreatic fistula rate with highly variable results. The aim of this study was to determine postoperative outcomes following various pancreatic stump-sealing methods. STUDY DESIGN: All cases of distal pancreatectomy were reviewed at a single institution between January 2008 and June 2011 and were monitored with complete 30-day outcomes through ACS-NSQIP. Pancreatic stump-sealing method was used to create three operation groups (suture, staple, or saline-linked radiofrequency). Two- and three-way statistical analyses were performed among the operation groups. RESULTS: Two hundred three patients underwent distal pancreatectomy. The most common diagnoses included chronic pancreatitis, adenocarcinoma, and IPMN. The suture, staple, and SLRF groups included 90 (44%), 61 (30%), and 52 (26%) patients, respectively. Overall complications (range 31-38%) and pancreatic fistula (range 25-26%) were similar with each pancreatic closure technique. Operative technique was not associated with an increased need for postoperative interventions or hospital readmission. CONCLUSIONS: Postoperative outcomes after distal pancreatectomy are unaffected by the use of SLRF sealing of the pancreatic stump when compared to traditional suture or reinforced stapling techniques.
BACKGROUND:Pancreatic fistula remains the primary source of morbidity following distal pancreatectomy. Previous studies have reported specific methods of parenchymal transection/stump sealing in an effort to decrease the pancreatic fistula rate with highly variable results. The aim of this study was to determine postoperative outcomes following various pancreatic stump-sealing methods. STUDY DESIGN: All cases of distal pancreatectomy were reviewed at a single institution between January 2008 and June 2011 and were monitored with complete 30-day outcomes through ACS-NSQIP. Pancreatic stump-sealing method was used to create three operation groups (suture, staple, or saline-linked radiofrequency). Two- and three-way statistical analyses were performed among the operation groups. RESULTS: Two hundred three patients underwent distal pancreatectomy. The most common diagnoses included chronic pancreatitis, adenocarcinoma, and IPMN. The suture, staple, and SLRF groups included 90 (44%), 61 (30%), and 52 (26%) patients, respectively. Overall complications (range 31-38%) and pancreatic fistula (range 25-26%) were similar with each pancreatic closure technique. Operative technique was not associated with an increased need for postoperative interventions or hospital readmission. CONCLUSIONS: Postoperative outcomes after distal pancreatectomy are unaffected by the use of SLRF sealing of the pancreatic stump when compared to traditional suture or reinforced stapling techniques.
Authors: Markus K Diener; Keyvan Tadjalli-Mehr; Keyvan-Tadjalli Mehr; Moritz N Wente; Meinhard Kieser; Markus W Büchler; Christoph M Seiler Journal: Langenbecks Arch Surg Date: 2010-10-21 Impact factor: 3.445
Authors: Nicholas A Hamilton; Matthew R Porembka; Fabian M Johnston; Feng Gao; Steven M Strasberg; David C Linehan; William G Hawkins Journal: Ann Surg Date: 2012-06 Impact factor: 12.969
Authors: David A Kooby; William G Hawkins; C Max Schmidt; Sharon M Weber; David J Bentrem; Theresa W Gillespie; Johnita Byrd Sellers; Nipun B Merchant; Charles R Scoggins; Robert C G Martin; Hong Jin Kim; Syed Ahmad; Clifford S Cho; Alexander A Parikh; Carrie K Chu; Nicholas A Hamilton; Courtney J Doyle; Scott Pinchot; Amanda Hayman; Rebecca McClaine; Attila Nakeeb; Charles A Staley; Kelly M McMasters; Keith D Lillemoe Journal: J Am Coll Surg Date: 2010-05 Impact factor: 6.113
Authors: Stephen W Behrman; Ben L Zarzaur; Abhishek Parmar; Taylor S Riall; Bruce L Hall; Henry A Pitt Journal: J Gastrointest Surg Date: 2014-08-13 Impact factor: 3.452
Authors: Janak Atul Parikh; Joal D Beane; E Molly Kilbane; Daniel P Milgrom; Henry A Pitt Journal: J Am Coll Surg Date: 2014-09-03 Impact factor: 6.113
Authors: Clifford S Cho; David A Kooby; C Max Schmidt; Attila Nakeeb; David J Bentrem; Nipun B Merchant; Alexander A Parikh; Ronald C G Martin; Charles R Scoggins; Syed A Ahmad; Hong J Kim; Nicholas Hamilton; William G Hawkins; Sharon M Weber Journal: Ann Surg Date: 2011-05 Impact factor: 12.969
Authors: William E Fisher; Christy Chai; Sally E Hodges; Meng-Fen Wu; Susan G Hilsenbeck; F Charles Brunicardi Journal: J Gastrointest Surg Date: 2008-02-14 Impact factor: 3.452
Authors: Shukri F Khuri; William G Henderson; Jennifer Daley; Olga Jonasson; R Scott Jones; Darrell A Campbell; Aaron S Fink; Robert M Mentzer; Janet E Steeger Journal: J Am Coll Surg Date: 2007-06 Impact factor: 6.113
Authors: Evan L Fogel; Safi Shahda; Kumar Sandrasegaran; John DeWitt; Jeffrey J Easler; David M Agarwal; Mackenzie Eagleson; Nicholas J Zyromski; Michael G House; Susannah Ellsworth; Ihab El Hajj; Bert H O'Neil; Attila Nakeeb; Stuart Sherman Journal: Am J Gastroenterol Date: 2017-01-31 Impact factor: 10.864
Authors: Joal D Beane; Michael G House; Susan C Pitt; E Molly Kilbane; Bruce L Hall; Abishek D Parmar; Taylor S Riall; Henry A Pitt Journal: HPB (Oxford) Date: 2015-07-22 Impact factor: 3.647
Authors: Marita D Bauman; David G Becerra; E Molly Kilbane; Nicholas J Zyromski; C Max Schmidt; Henry A Pitt; Attila Nakeeb; Michael G House; Eugene P Ceppa Journal: Surg Endosc Date: 2017-06-22 Impact factor: 4.584
Authors: Noah S Rozich; Katherine T Morris; Tabitha Garwe; Zoona Sarwar; Alessandra Landmann; Chesney B Siems; Alexandra Jones; Casey S Butler; Paul K McGaha; Benjamin C Axtman; Barish H Edil; Jason S Lees Journal: J Trauma Acute Care Surg Date: 2019-12 Impact factor: 3.697
Authors: Muhammad Umair Bashir; Apostolos Kandilis; Nancy M Jackson; Janak A Parikh; Michael J Jacobs Journal: Ann Hepatobiliary Pancreat Surg Date: 2020-05-31
Authors: Elke Tieftrunk; Ihsan Ekin Demir; Stephan Schorn; Mine Sargut; Florian Scheufele; Lenika Calavrezos; Rebekka Schirren; Helmut Friess; Güralp O Ceyhan Journal: PLoS One Date: 2018-06-13 Impact factor: 3.240