Efficacy of the slow firing method using a reinforced triple-row stapler for preventing postoperative pancreatic fistula during laparoscopic distal pancreatectomy
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...
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Published in | Surgery today (Tokyo, Japan) Vol. 52; no. 2; pp. 260 - 267 |
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Main Authors | , , , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
Singapore
Springer Singapore
01.02.2022
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Subjects | |
Online Access | Get full text |
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Summary: | 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. |
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Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
ISSN: | 0941-1291 1436-2813 |
DOI: | 10.1007/s00595-021-02344-z |