Operative Procedures Using a Curved Cutter Stapler for the Prevention of Pancreatic Fistula after Distal Pancreatectomy

Aim Although numerous techniques to prevent postoperative pancreatic fistula after distal pancreatectomy have been attempted, the optimal method for pancreatic stump closure remains controversial. The aim of this retrospective cohort study was to evaluate the effectiveness of using a Curved Cutter Stapler® in the prevention of postoperative pancreatic fistula after distal pancreatectomy. Patients and Methods The records of a total of 35 patients (male, n=15, female, n=20) who underwent distal pancreatectomy using a Curved Cutter Stapler were reviewed. The patients were divided into two groups according to the absence or presence of postoperative pancreatic fistula. The relationship between the perioperative factors and postoperative pancreatic fistula was investigated. Results After PD, Grade A postoperative pancreatic fistula occurred in 4 patients (11%) and Grade B postoperative pancreatic fistula occurred in 2 patients (6%); no patients developed Grade C postoperative pancreatic fistula. There were no significant differences between the fistula and non-fistula groups with regard to the preoperative and intraoperative demographic data and relevant risk factors, including the thickness and texture of the pancreatic parenchyma. Conclusion Pancreatic resection using a Curved Cutter Stapler would contribute to the reduction of pancreatic fistula. The use of a Curved Cutter Stapler was thought to be favorable for the prevention of pancreatic fistula in any type of pancreas.

Author(s): Masashi Ishikawa, Yoshihiko Tashiro, Masaki Yamamoto, Hirokazu Takechi, Kazuo Matsuyama, Takayuki Miyauchi, Taketo Oshio, Tetsuya Kitagawa

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