Department of General Surgery, Adana City Training and Research Hospital, Adana, Turkey.
Department of Surgical Oncology, Adana City Training and Research Hospital, Adana, Turkey.
J Coll Physicians Surg Pak. 2021 Oct;31(10):1214-1218. doi: 10.29271/jcpsp.2021.10.1214.
To analyse clinicopathological variables to determine risk factors of postoperative pancreatic fistula in patients having distal pancreatectomy with stapler closure.
Observational study.
Adana City Training and Research Hospital, Adana, Turkey, from January 2015 to May 2020.
Medical files of 38 cases having distal pancreatectomy with stapler closure of the pancreatic remnant for conditions emerging from the pancreas or other organs were analysed. Data about demographics, perioperative and pathological findings, postoperative outcomes were gathered. Univariate analysis was utilised for comparisons of categorical data. The possible risk factors found to be significant in the univariate analysis were included into the logistic regression analysis.
Based on the description reported by the International Study Group of Pancreatic Surgery, 23.7% and 31.6% of the patients had biochemical leakage and clinically relevant postoperative pancreatic fistula (POPF) respectively. Univariate and multivariate analyses made to determine risk factors of POPF showed a relation between stapler closure alone (p = 0.018) and soft parenchymal texture (p = 0.002) and clinically relevant POPF. Multivariate analyses revealed that parenchymal texture was the sole independent predictor of clinically relevant POPF (OR, 0.016, p = 0.039).
Soft pancreatic texture is independently predictive of clinically relevant POPF following distal pancreatectomy with stapler closure. However, reinforcement of the stapler line with extra sutures decreases the risk of clinically relevant POPF. Key Words: Distal pancreatectomy, Pancreatic fistula, Stapler closure, Suture reinforcement.
分析临床病理变量，以确定使用吻合器行胰体尾切除术患者术后发生胰瘘的危险因素。
观察性研究。
土耳其阿达纳市培训与研究医院，2015 年 1 月至 2020 年 5 月。
分析了 38 例行胰体尾切除术的患者的医疗档案，这些患者的胰腺残端均使用吻合器吻合，用于治疗胰腺或其他器官的疾病。收集了人口统计学、围手术期和病理发现以及术后结果的数据。使用单变量分析比较分类数据。将单变量分析中发现的可能危险因素纳入逻辑回归分析。
根据国际胰腺外科研究组的描述，23.7%和 31.6%的患者分别发生生化漏和临床上有意义的术后胰瘘（POPF）。单变量和多变量分析确定了 POPF 的危险因素，结果显示吻合器单独使用（p = 0.018）和胰腺质地柔软（p = 0.002）与临床上有意义的 POPF 有关。多变量分析显示，胰腺质地是临床上有意义的 POPF 的唯一独立预测因素（OR，0.016，p = 0.039）。
在使用吻合器行胰体尾切除术时，胰腺质地柔软是临床上有意义的 POPF 的独立预测因素。然而，额外缝线加固吻合器线可降低临床上有意义的 POPF 的风险。关键词：胰体尾切除术、胰瘘、吻合器吻合、缝线加固。
