1. Efficacy of the slow firing method using a reinforced triple-row stapler for preventing postoperative pancreatic fistula during laparoscopic distal pancreatectomy.
- Author
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Matsumoto, Ippei, Kamei, Keiko, Satoi, Shumpei, Murase, Takaaki, Matsumoto, Masataka, Kawaguchi, Kohei, Yoshida, Yuta, Dongha, Lee, Takebe, Atsushi, Nakai, Takuya, and Takeyama, Yoshifumi
- Subjects
PANCREATECTOMY ,PANCREATIC fistula ,LAPAROSCOPIC surgery ,PANCREAS - Abstract
Purpose: Postoperative pancreatic fistula (POPF) remains the most clinically relevant complication of laparoscopic distal pancreatectomy (LDP). The present study evaluated the efficacy of the "slow firing method" using a reinforced triple-row stapler (Covidien, Tokyo, Japan) during LDP. Methods: This retrospective single-center study included 73 consecutive patients who underwent LDP using the slow firing method. A black cartridge was used in all patients. The primary endpoint was the rate of clinically relevant POPF (CR-POPF) after LDP. Secondary endpoints included perioperative outcomes and factors associated with CR-POPF as well as the correlation between the transection time and thickness of the pancreas. Results: Four patients (5.5%) developed CR-POPF (grade B). Overall morbidity rates, defined as grade ≥ II and ≥ III according to the Clavien-Dindo classification, were 21 and 11%, respectively. The median postoperative hospital stay was 10 days. Preoperative diabetes (13.6 vs. 0.2%, P = 0.044) and thickness of the pancreas ≥ 15 mm (13.8% vs. 0%, P = 0.006) were identified as independent risk factors for CR-POPF. The median transection time was 16 (8–29) min. Conclusion: The slow firing method using a reinforced triple-row stapler for pancreatic transection is simple, safe, and effective for preventing CR-POPF after LDP. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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