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Transpancreatic mattress suture with Vicryl mesh around the stump decreases postoperative pancreatic fistula after distal pancreatectomy
Author(s) -
Yoshida Yuta,
Matsumoto Ippei,
Matsumoto Masataka,
Kawaguchi Kohei,
Murase Takaaki,
Kamei Keiko,
Satoi Shumpei,
Takebe Atsushi,
Nakai Takuya,
Takeyama Yoshifumi
Publication year - 2019
Publication title -
journal of hepato‐biliary‐pancreatic sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 1868-6974
DOI - 10.1002/jhbp.664
Subject(s) - medicine , pancreatic fistula , surgery , distal pancreatectomy , fibrous joint , single center , complication , vicryl , fistula , retrospective cohort study , resection , pancreas
Background Postoperative pancreatic fistula ( POPF ) after distal pancreatectomy ( DP ) remains the most common surgical complication. We have developed a novel stump closure technique after DP using transpancreatic mattress suture with Vicryl mesh ( TMV ) and reported our initial findings. The purpose of this study is to evaluate the efficacy of TMV compared to the conventional handsewn stump closure technique ( CHS ). Methods This retrospective single‐center study included 165 consecutive patients who underwent open DP from January 2010 to May 2018. Of these, 71 patients underwent DP using TMV after September 2014 and 94 patients underwent DP with CHS . The surgical outcomes were compared between the two groups. Results Clinically relevant POPF rate in the TMV group was significantly lower than that in the CHS group (5.6% vs. 17.2%, P = 0.027). Morbidity rate was higher in the CHS group than that in the TMV group (16.9% vs. 27.7%, P = 0.104). In the multivariate analysis, absence of additional organ resection ( OR 3.57; 95% CI 1.18–10.43; P = 0.025) and TMV ( OR 0.24; 95% CI 0.07–0.73; P = 0.010) were identified as independent preventing factors for clinically relevant POPF . Conclusion TMV can be an effective stump closure technique for preventing POPF after DP .