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Retroperitonealization of the Pancreatic Stump in Distal Pancreatectomy: a Novel Technique to Reduce Postoperative Pancreatic Fistula

Overview
Specialty General Surgery
Date 2023 Nov 2
PMID 37914974
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Abstract

Purpose: To evaluate the efficacy and safety of retroperitonealization of the pancreatic stump in distal pancreatectomy.

Methods: Clinical data from the Tongji Hospital pancreatic database were retrospectively reviewed in this study. The data of 68 patients who underwent retroperitonealized distal pancreatectomy from January, 2019, to April, 2021, were collected and analyzed. Sixty-four patients who underwent conventional distal pancreatectomy during the same period were matched. We compared and analyzed the operative outcomes and postoperative complications between the patients in the two groups before and after propensity score matching (PSM).

Results: Before PSM, the operative outcomes and postoperative complications were comparable between the two groups. After PSM, the retroperitonealized group had a lower incidence of postoperative pancreatic fistula (POPF) (10.53% vs 31.58%, P = 0.047) and shorter time until drainage removal (10.00, 8.00-13.00 days vs 13.00, 10.00-18.00 days, P = 0.005). In the univariate and multivariate regression analyses, non-retroperitonealization and intra-abdominal infection were found to be independent risk factors for postoperative pancreatic fistula (POPF).

Conclusion: Retroperitonealization of the pancreatic stump can reduce the incidence of POPF after distal pancreatectomy.

References
1.
Postlewait L, Kooby D . Laparoscopic distal pancreatectomy for adenocarcinoma: safe and reasonable?. J Gastrointest Oncol. 2015; 6(4):406-17. PMC: 4502162. DOI: 10.3978/j.issn.2078-6891.2015.034. View

2.
Gouillat C, Gigot J . Pancreatic surgical complications--the case for prophylaxis. Gut. 2002; 49 Suppl 4:iv32-9. PMC: 1766893. DOI: 10.1136/gut.49.suppl_4.iv29. View

3.
Maggino L, Malleo G, Bassi C, Allegrini V, McMillan M, Borin A . Decoding Grade B Pancreatic Fistula: A Clinical and Economical Analysis and Subclassification Proposal. Ann Surg. 2019; 269(6):1146-1153. DOI: 10.1097/SLA.0000000000002673. View

4.
Jiang L, Ning D, Chen X . Prevention and treatment of pancreatic fistula after pancreatic body and tail resection: current status and future directions. Front Med. 2019; 14(3):251-261. DOI: 10.1007/s11684-019-0727-3. View

5.
Mezhir J . Management of complications following pancreatic resection: an evidence-based approach. J Surg Oncol. 2012; 107(1):58-66. DOI: 10.1002/jso.23139. View