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Surg Today ; 52(2): 260-267, 2022 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-34322726

RESUMEN

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.


Asunto(s)
Laparoscopía/métodos , Pancreatectomía/métodos , Fístula Pancreática/prevención & control , Complicaciones Posoperatorias/prevención & control , Engrapadoras Quirúrgicas , Grapado Quirúrgico/métodos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Glicósidos , Humanos , Masculino , Persona de Mediana Edad , Tempo Operativo , Pregnanos , Factores de Riesgo , Seguridad , Grapado Quirúrgico/instrumentación , Resultado del Tratamiento , Adulto Joven
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