Distal Pancreatectomy - OWN Experience

• Authors: Marek Olakowski , Beata Jabłońska , Łukasz Braszczok , Andrzej Lekstan , Paweł Bednarek , Agnieszka Bratek , Anna Bocheńska , Paweł Lampe
• Languages of publication: EN

Abstracts

EN

The aim of the study was the retrospective analysis of early results after distal pancreatectomy (DP).Material and methods. During the period between January, 2000 and December, 2010 distal pancreatectomy was performed in 73 patients, including 32 (43.83%) male, and 41 (56.16%) female patients. Average patient age amounted to 53.92 ± 14.37 years. Surgery was performed by means of laparoscopy or the classical method.Results. The mean duration of the procedure amounted to 179.79 ± 59.90 minutes. Fifty-nine (80.82%) patients were subject to splenectomy. After the resection the pancreatic stump was hand-sewn in 69 patients. Pancreatoenterostomy was performed in 4 (5.47%) patients. Early postoperative complications occurred in 11 (15%) patients. Reoperation was required in two (2.7 %) patients. The postoperative mortality rate amounted to 2.7%. The average hospitalization period after surgery amounted to 12.72 ± 9.8 (1- 66) days.Conclusions. Distal pancreatectomy performed in a center experienced in pancreatic surgery is a safe procedure characterized by a low rate of complications and mortality.

Keywords

EN

distal pancreatectomy; peripheral pancreatic resection

• Journal: Polish Journal of Surgery
• Year: 2012
• Volume: 84
• Issue: 6
• Pages: 298-303

Dates

published

1 - 6 - 2012

online

28 - 7 - 2012

Contributors

author

Marek Olakowski

• Department of Gastrointestinal Surgery, Silesian Medical University in Katowice

author

Beata Jabłońska

• Department of Gastrointestinal Surgery, Silesian Medical University in Katowice

author

Łukasz Braszczok

• Department of Gastrointestinal Surgery, Silesian Medical University in Katowice

author

Andrzej Lekstan

• Department of Gastrointestinal Surgery, Silesian Medical University in Katowice

author

Paweł Bednarek

• Student Scientific Society, Department of GI Surgery, SMU in Katowice

author

Agnieszka Bratek

• Student Scientific Society, Department of GI Surgery, SMU in Katowice

author

Anna Bocheńska

• Student Scientific Society, Department of GI Surgery, SMU in Katowice

author

Paweł Lampe

• Department of Gastrointestinal Surgery, Silesian Medical University in Katowice

References

• Lorenz U, Maier M, Steger U et al.: Analysis of closure of the pancreatic remnant after distal pancreatic resection. HPB (Oxford) 2007; 9: 302-07.
• Hutchins RR, Hart RS, Pacifico M: Long-Term Results of Distal Pancreatectomy for Chronic Pancreatitis in 90 Patients. Ann Surg 2002; 236: 612-18.
• Casadei R, Ricci C, Pezzilli R et al.: Assessment of Complications According to the Clavien-Dindo Classification After Distal Pancreatectomy. JOP. J Pancreas (Online) 2011; 12: 126-30.
• Simons JP, Shah SA, Ng SC et al.: National complication rates after pancreatectomy: beyond mere mortality. J Gastrointest Surg 2009; 13: 1798-05.[Crossref][WoS]
• Yoshioka R, Saiura A, Koga R et al.: Risk factors for clinical pancreatic fistula after distal pancreatectomy: analysis of consecutive 100 patients. World J Surg 2010; 34: 121-25.[WoS]
• Fahy BN, Frey CF, Ho HS et al.: Morbidity, mortality, and technical factors of distal pancreatectomy. Am J Surg 2002; 183: 237-41.
• Balcom JH 4th, Rattner DW, Warshaw AL et al.: Ten-year experience with 733 pancreatic resections: changing indications, older patients, and decreasing length of hospitalization. Arch Surg 2001; 136: 391-98.
• Bassi C, Dervenis C, Butturini G et al.: Postoperative pancreatic fistula: an international study group (ISGPF) definition. Surgery 2005; 138: 8-13.
• Buchler MW, Wagner M, Schmied BM et al.: Changes in morbidity after pancreatic resection: toward the end of completion pancreatectomy. Arch Surg 2003; 138: 1310-14.
• Fernandez-del CC, Rattner DW, Warshaw AL Standards for pancreatic resection in the 1990s. Arch Surg 1995; 130: 295-99.
• van Heek NT, Kuhlmann KF, Scholten RJ et al.: Hospital volume and mortality after pancreatic resection: a systematic review and an evaluation of intervention in the Netherlands. Ann Surg 2005; 242: 781-88.
• Neoptolemos JP, Russell RC, Bramhall S et al.: Low mortality following resection for pancreatic and periampullary tumours in 1026 patients: UK survey of specialist pancreatic units. UK Pancreatic Cancer Group. Br J Surg 1997; 84: 1370-76.
• Rodriguez JR, Germes SS, Pandharipande PV et al.: Implications and cost of pancreatic leak following distal pancreatic resection. Arch Surg 2006; 141: 361-65.
• Lillemoe KD, Kaushal S, Cameron JL et al.: Distal pancreatectomy: indications and outcomes in 235 patients. Ann Surg 1999; 229: 693-700.
• Balzano G, Zerbi A, Cristallo M et al.: The unsolved problem of fistula after left pancreatectomy: the benefit of cautious drain management. J Gastrointest Surg 2005; 9: 837-42.[Crossref]
• Suzuki Y, Fujino Y, Tanioka Y et al.: Randomized clinical trial of ultrasonic dissector or conventional division in distal pancreatectomy for nonfibrotic pancreas. Br J Surg 1999; 86: 608-11.
• Adam U, Makowiec F, Riediger H et al.: Distal pancreatic resection - indications, techniques and complications. Zentralbl Chir 2001; 126: 908-12.
• Moriura S, Kimura A, Ikeda S et al.: Closure of the distal pancreatic stump with a seromuscular flap. Surg Today 1995; 25: 992-94.
• Kluger Y, Alfici R, Abbley B et al.: Gastric serosal patch in distal pancreatectomy for injury: a neglected technique. Injury 1997; 28: 127-29.
• Ohwada S, Ogawa T, Tanahashi Y et al.: Fibrin glue sandwich prevents pancreatic fistula following distal pancreatectomy. World J Surg 1998; 22: 494-98.
• Suzuki Y, Kuroda Y, Morita A et al.: Fibrin glue sealing for the prevention of pancreatic fistulas following distal pancreatectomy. Arch Surg 1995; 130: 952-55.
• Diener MK, Seiler CM, Rossion I et al.: Efficacy of stapler versus hand-sewn closure after distal pancreatectomy (DISPACT): a randomised, controlled multicentre trial. Lancet 2011 30; 377: 1514-22.
• Kleeff J, Diener MK, Z'graggen K et al.: Distal pancreatectomy: risk factors for surgical failure in 302 consecutive cases. Ann Surg 2007; 245: 573-82.
• Bilimoria MM, Cormier JN, Mun Y et al.: Pancreatic leak after left pancreatectomy is reduced following main pancreatic duct ligation. Br J Surg 2003; 90: 190-96.
• Pannegeon V, Pessaux P, Sauvanet A et al.: Pancreatic fistula after distal pancreatectomy: predictive risk factors and value of conservative treatment. Arch Surg 2006; 141: 1071-76.
• Yamaguchi K, Noshiro H, Yokohata K et al.: Is there any benefit of preservation of the spleen in distal pancreatectomy? Int Surg 2001; 86: 162-68.
• Rodríguez JR, Madanat MG, Healy BC et al.: Distal pancreatectomy with splenic preservation revisited. Surgery 2007; 141: 619-25.[WoS]
• Shoup M, Brennan MF, McWhite K et al.: The value of splenic preservation with distal pancreatectomy. Arch Surg 2002; 137: 164-68.
• Goh BK, Tan YM, Chung YF et al.: Critical appraisal of 232 consecutive distal pancreatectomies with emphasis on risk factors, outcome, and management of the postoperative pancreatic fistula: a 21-year experience at a single institution. Arch Surg 2008; 143: 956-65.[WoS]
• Frozanpor F, Albiin N, Linder S et al.: Impact of pancreatic gland volume on fistula formation after pancreatic tail resection. JOP 2010; 11: 439-43.
• Vijan SS, Ahmed KA, Harmsen WS et al.: Laparoscopic vs open distal pancreatectomy: a singleinstitution comparative study. Arch Surg 2010; 145: 616-21.
• Casadei R, Ricci C, D'Ambra M et al.: Laparoscopic versus open distal pancreatectomy in pancreatic tumours: a case-control study. Updates Surg 2010; 62: 171-74.
• Kooby DA, Hawkins WG, Schmidt CM et al.: A multicenter analysis of distal pancreatectomy for adenocarcinoma: is laparoscopic resection appropriate? J Am Coll Surg 2010; 210: 779-85.
• Bruns H, Rahbari NN, Löffler T et al.: Perioperative management in distal pancreatectomy: results of a survey in 23 European participating centres of the DISPACT trial and a review of literature. Trials 2009; 10: 58.[WoS]

Identifiers

DOI

10.2478/v10035-012-0050-z