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Polysorb^R(an absorbable lactomer) staples, a safe closure technique for distal pancreatic resection

World Journal of Gastroenterology 2014年第45期20卷 17185-17189页

作者： Gyula Farkas László Leindler János Márton Gyorgy Lázár Gyula Farkas Department of Surgery Faculty of Medicine University of Szeged H-6701 SzegedHungary

AIM:To investigate twenty-year experience evaluated the use of the PolysorbR(an absorbable lactomer)staples for distal pancreatic ***:The data on 150 patients[92 men,58women,mean age 52(24-72)years]who underwent distal pancreatectomy(DP)in the last 20 years were collected prospectively from an electronic *** diagnosis was confirmed by endoscopic retrograde cholangiopancreatography,sonography,computed tomography and/or magnetic resonance *** indications for DP were focal pancreatic necrosis,spontaneous pancreatic fistulas,abscesses,pseudocysts,segmental chronic obstructive pancreatitis in the tail,traumatic disruption,and benign(cystadenomas,insulinomas,or glucagonomas)or malignant *** distal resections were performed without splenectomy in 29 of the 150 patients(19%).In the event of splenectomy,the splenic artery and vein were individually ligated,the TA-55 Auto Suture stapler,loaded with Premium PolysorbR 55 staples(5.5mm),was placed across the gland,and the trigger was pulled,the action of which produced two staggered absorbable suture *** gland distal to the stapler wasthen amputated with a scalpel on the TA-55 stapler and the two rows of staples were left in the proximal pancreatic *** the distal resection,a drainage tube was inserted into the pancreatic ***:The average duration of the operation was150 min(range:90-210 min)and no transfusion was indicated during the *** DP in one patient a type B fistula was diagnosed,which was treated successfully by conservative treatment comprising of 12-d octreotide medication(3×0.1 mg/d)and jejunal *** incidence of postoperative pancreatic fistula was therefore0.6%.Another 2 patients suffered postoperative pancreatitis,which was also conservatively *** were performed in 2 patients on the first or second postoperative day,necessitated by bleeding from the retroperitoneal *** morbidity was 3.3%(5 patients),but no mortality

关键词： distal pancreatic resection PolysorbR sta-ples Closure technique Long-term experience Pancre-atic fistula

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Laparoscopic versus open distal pancreatectomy for benign or premalignant pancreatic neoplasms: a two-center comparative study

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2015年第7期16卷 573-579页

作者： Jia-fei YAN Tian-tao KUANG Da-yong JI Xiao-wu XU Dan-song WANG Ren-chao ZHANG Wei-wei JIN Yi-ping MOU Wen-hui LOU Department of General Surgery Institute of Micro-Invasive Surgery Sir Run Run Shaw HospitalSchool of Medicine Zhejiang University Department of General Surgery Zhongshan Hospital Shanghai Medical College Fudan University

Objective： To compare the peri-operative outcomes for laparoscopic distal pancreatectomy（LDP） and open distal pancreatectomy（ODP） for benign or premalignant pancreatic neoplasms in two institutions. Methods： This prospective comparative study included 91 consecutive patients who underwent LDP（n=45） or ODP（n=46） from Jan. 2010 to Dec. 2012. Demographics, intra-operative characteristics, and post-operative outcomes were compared. Results： The median operating time in the LDP group was（158.7±38.3） min compared with（92.2±24.1） min in the ODP group（P〈0.001）. Patients had lower blood loss in LDP than in the ODP（（122.6±61.1） ml vs.（203.1±84.8） ml, P〈0.001）. The rates of splenic conservation between the LDP and ODP groups were similar（53.3% vs. 47.8%, P=0.35）. All spleen-preserving distal pancreatectomies were conducted with vessel preservation. LDP also demonstrated better post-operative outcomes. The time to oral intake and normal daily activities was faster in the LDP group than in the ODP group（（1.6±0.5） d vs.（3.2±0.7） d, P〈0.01;（1.8±0.4） d vs.（2.1±0.6） d, P=0.02, respectively）, and the postoperative length of hospital stay in LDP was shorter than that in ODP（（7.9±3.8） d vs.（11.9±5.8） d, P=0.006）. No difference in tumor size（（4.7±3.2） cm vs.（4.5±1.8） cm, P=0.77） or overall pancreatic fistula rate（15.6% vs. 19.6%, P=0.62） was found between the groups, while the overall post-operative complication rate was lower in the LDP group（26.7% vs. 47.8%, P=0.04）. Conclusions： LDP is safe and effective for benign or premalignant pancreatic neoplasms, featuring lower blood loss and substantially faster recovery.

关键词： Laparoscopy distal pancreatic resection pancreatic neoplasm Splenic preservation pancreatic benign tumors

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