TITLE

Staple line reinforcement reduces postoperative pancreatic stump leak after distal pancreatectomy

AUTHOR(S)
Jimenez, Ramon E.; Mavanur, Arun; Macaulay, William P.
PUB. DATE
March 2007
SOURCE
Journal of Gastrointestinal Surgery;Mar2007, Vol. 11 Issue 3, p345
SOURCE TYPE
Academic Journal
DOC. TYPE
journal article
ABSTRACT
Pancreatic stump leak is the major source of morbidity after stapled distal pancreatectomy. We hypothesized that reinforcement of the stapler system with a buttress mat can improve leak rates when compared to standard stapling alone. We performed 13 consecutive distal pancreatectomies using our reinforced stapler system, forming our experimental group. A historical control group was composed of 18 patients undergoing stapled pancreatic closure without reinforcement. The main outcome measure was pancreatic leak in the postoperative period. Pancreatic leaks included fistulas and fluid collections (sterile or infected). Hospital length of stay was recorded as a secondary measure. Postoperative pancreatic leak rate was zero in the experimental group, but 39% in the control group (P = 0.025). Development of a pancreatic leak resulted in prolonged hospital stays: 13.6 vs 8.3 days (P < 0.03). We conclude that staple line reinforcement is a simple and effective method of reducing pancreatic stump leakage after distal pancreatectomy. The economic impact of lower leak rates is reflected in significantly shorter hospital stays. The results of our study should be validated in a randomized controlled trial.
ACCESSION #
27976724

 

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