A Novel Technique of Slow Compression Using the Intestinal Clamp for Distal Pancreatectomy

Background Pancreatic fistula remains a serious complication after distal pancreatectomy, despite the development of various useful devices and techniques. Accordingly, the clinical benefits of closure using a stapler remain controversial. Study design We retrospectively reviewed the records of 50 patients who underwent open distal pancreatectomy for various diseases. For the first 20 patients, who underwent surgery from April 2007 to June 2012, a stapler was used to compress the pancreas before transection (the conventional transection group), whereas slow compression using an intestinal clamp (the intestinal clamp group) was performed for the remaining 27 patients from July 2012 to October 2015, excluding 3 pancreatic cancer who underwent additional resection. We compared both groups for various factors. Results (one to two paragraphs). Ten patients in the conventional transection group developed pancreatic fistula of which five were grade B. On the other hand, only four patients in the intestinal clamp group developed pancreatic fistula (p = 0.03) of which only one was grade B. The median time for the patient to consume a meal was shorter in the intestinal clamp group than conventional resection group. Conclusions Our technique provides many advantages, as it is a simple, convenient, and quick technique to reduce the incidence of pancreatic fistula.

Author(s): Tetsunosuke Shimizu, Yoshiharu Miyamato, Mitsuhiro Asakuma, Yoshihiro Inoue, Koji Komeda, Fumitoshi Hirokawa, Michihiro Hayashi, Kazuhisa Uchiyama

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