Staple closure of the pancreas.

Since modern surgical stapling instruments have found a wide range of usefulness in gastrointestinal surgery, we have attempted to establish the feasibility of staple rather than suture closure of the transected pancreas. Distal pancreatic resection has been performed in eight dogs utilizing the Auto Suture Model TA-55 surgical staple instrument for primary closure of the transected margin of the remaining pancreas. Serial serum amylase determinations for each of the animals remained within normal range. Each animal was sacrificed one week after the initial surgery with examination of the remaining pancreas. None of the animals demonstrated any evidence of pancreatic fistula or abscess. Similar technique for distal pancreatic resection has been utilized in 12 patients. Five of the resections were performed for malignancies, four for trauma, and three for benign pancreatic disease. In each case, the residual pancreas was closed with the TA-55 surgical staple instrument. Although two patients died during the postoperative period of causes unrelated to the pancreas, none developed either fistula or other evidence of difficulty in healing of the pancreas. It is our conclusion that staple closure of the transected margin of the pancreas is a reasonable and safe alternative to standard suture closure technique.