THE DEPENDENCE OF DIRECT RESULTS OF DISTAL PANCREATECTOMIES ON DIFFERENT PANCREATIC STUMP CLOSURE TECHNIQUES
The OBJECTIVE is to study the effect of application of different pancreatic stump closure techniques to the postoperative period, the frequency and severity of postoperative complications including postoperative pancreatic fistulas after distal pancreatectomies. MATERIAL AND METHODS. ...
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| Format: | Article |
| Language: | Russian |
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Pavlov First Saint Petersburg State Medical University
2018-08-01
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| Series: | Вестник хирургии имени И.И. Грекова |
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| Online Access: | https://www.vestnik-grekova.ru/jour/article/view/983 |
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| author | S. E. Voskanyan E. V. Naydenov I. Yu. Uteshev A. I. Artemiev Yu. D. Udalov M. V. Zabelin |
| author_facet | S. E. Voskanyan E. V. Naydenov I. Yu. Uteshev A. I. Artemiev Yu. D. Udalov M. V. Zabelin |
| author_sort | S. E. Voskanyan |
| collection | DOAJ |
| description | The OBJECTIVE is to study the effect of application of different pancreatic stump closure techniques to the postoperative period, the frequency and severity of postoperative complications including postoperative pancreatic fistulas after distal pancreatectomies. MATERIAL AND METHODS. The clinical material consisted of 126 patients who underwent distal pancreatectomies (isolated or in combination with surgical interventions on the adjacent organs of the abdominal cavity and retroperitoneal space). The patients were divided into 4 groups depending on the pancreatic stump closure techniques (isolated suturing of the main pancreatic duct of the pancreatic stump with its omentization by gastrocolic omentum or local sealing its by hemostatic sponge (control group); using a local biological glue 2-octylcyanoacrylate; using the Endoscopic Linear Cutter Echelon; external transduodenal transnasal drainage of the enlarged main pancreatic duct of the pancreatic stump). We evaluated the influence of different pancreatic stump closure techniques after distal pancreatectomies on the postoperative period as well the frequency and severity of postoperative pancreatic fistulas depending on the diameter of the main pancreatic duct of pancreatic stump. RESULTS. The overall rate of postoperative complications in the control group of patients was 45.8 %, and was due to an increase in the frequency of specific complications (35.4 %). The most frequent complication in the control group of patients was postoperative pancreatic fistulas – 29.2 %. The statistically significant decrease of frequency and severity of postoperative complications, frequency and severity of postoperative pancreatic fistulas and decrease of postoperative hospital-stay after the application of the proposed different pancreatic stump closure techniques were revealed in comparison with the control group of patients. There was no hospital mortality. CONCLUSION. Distal pancreatectomy with «standard» pancreatic stump closure techniques accompanied by high frequency and severity of postoperative complications, as well as postoperative pancreatic fistulas. The use of the proposed pancreatic stump closure techniques after distal pancreatectomy led to a decrease of the frequency and severity of postoperative complications, a decrease of the frequency and severity of postoperative pancreatic fistulas, and a decrease of the postoperative hospital-stay. |
| format | Article |
| id | doaj-art-08af534a8c3644e0b3641d29093c2b50 |
| institution | Kabale University |
| issn | 0042-4625 |
| language | Russian |
| publishDate | 2018-08-01 |
| publisher | Pavlov First Saint Petersburg State Medical University |
| record_format | Article |
| series | Вестник хирургии имени И.И. Грекова |
| spelling | doaj-art-08af534a8c3644e0b3641d29093c2b502025-08-20T04:00:34ZrusPavlov First Saint Petersburg State Medical UniversityВестник хирургии имени И.И. Грекова0042-46252018-08-011774232710.24884/0042-4625-2018-177-4-23-27883THE DEPENDENCE OF DIRECT RESULTS OF DISTAL PANCREATECTOMIES ON DIFFERENT PANCREATIC STUMP CLOSURE TECHNIQUESS. E. Voskanyan0E. V. Naydenov1I. Yu. Uteshev2A. I. Artemiev3Yu. D. Udalov4M. V. Zabelin5State Research Center – Burnasyan Federal Medical Biophysical Center of Federal Medical Biological AgencyState Research Center – Burnasyan Federal Medical Biophysical Center of Federal Medical Biological AgencyState Research Center – Burnasyan Federal Medical Biophysical Center of Federal Medical Biological AgencyState Research Center – Burnasyan Federal Medical Biophysical Center of Federal Medical Biological AgencyState Research Center – Burnasyan Federal Medical Biophysical Center of Federal Medical Biological AgencyState Research Center – Burnasyan Federal Medical Biophysical Center of Federal Medical Biological AgencyThe OBJECTIVE is to study the effect of application of different pancreatic stump closure techniques to the postoperative period, the frequency and severity of postoperative complications including postoperative pancreatic fistulas after distal pancreatectomies. MATERIAL AND METHODS. The clinical material consisted of 126 patients who underwent distal pancreatectomies (isolated or in combination with surgical interventions on the adjacent organs of the abdominal cavity and retroperitoneal space). The patients were divided into 4 groups depending on the pancreatic stump closure techniques (isolated suturing of the main pancreatic duct of the pancreatic stump with its omentization by gastrocolic omentum or local sealing its by hemostatic sponge (control group); using a local biological glue 2-octylcyanoacrylate; using the Endoscopic Linear Cutter Echelon; external transduodenal transnasal drainage of the enlarged main pancreatic duct of the pancreatic stump). We evaluated the influence of different pancreatic stump closure techniques after distal pancreatectomies on the postoperative period as well the frequency and severity of postoperative pancreatic fistulas depending on the diameter of the main pancreatic duct of pancreatic stump. RESULTS. The overall rate of postoperative complications in the control group of patients was 45.8 %, and was due to an increase in the frequency of specific complications (35.4 %). The most frequent complication in the control group of patients was postoperative pancreatic fistulas – 29.2 %. The statistically significant decrease of frequency and severity of postoperative complications, frequency and severity of postoperative pancreatic fistulas and decrease of postoperative hospital-stay after the application of the proposed different pancreatic stump closure techniques were revealed in comparison with the control group of patients. There was no hospital mortality. CONCLUSION. Distal pancreatectomy with «standard» pancreatic stump closure techniques accompanied by high frequency and severity of postoperative complications, as well as postoperative pancreatic fistulas. The use of the proposed pancreatic stump closure techniques after distal pancreatectomy led to a decrease of the frequency and severity of postoperative complications, a decrease of the frequency and severity of postoperative pancreatic fistulas, and a decrease of the postoperative hospital-stay.https://www.vestnik-grekova.ru/jour/article/view/983pancreasdistal pancreatectomycorporocaudal pancreatectomypancreatic tumorspostoperative pancreatic fistula |
| spellingShingle | S. E. Voskanyan E. V. Naydenov I. Yu. Uteshev A. I. Artemiev Yu. D. Udalov M. V. Zabelin THE DEPENDENCE OF DIRECT RESULTS OF DISTAL PANCREATECTOMIES ON DIFFERENT PANCREATIC STUMP CLOSURE TECHNIQUES Вестник хирургии имени И.И. Грекова pancreas distal pancreatectomy corporocaudal pancreatectomy pancreatic tumors postoperative pancreatic fistula |
| title | THE DEPENDENCE OF DIRECT RESULTS OF DISTAL PANCREATECTOMIES ON DIFFERENT PANCREATIC STUMP CLOSURE TECHNIQUES |
| title_full | THE DEPENDENCE OF DIRECT RESULTS OF DISTAL PANCREATECTOMIES ON DIFFERENT PANCREATIC STUMP CLOSURE TECHNIQUES |
| title_fullStr | THE DEPENDENCE OF DIRECT RESULTS OF DISTAL PANCREATECTOMIES ON DIFFERENT PANCREATIC STUMP CLOSURE TECHNIQUES |
| title_full_unstemmed | THE DEPENDENCE OF DIRECT RESULTS OF DISTAL PANCREATECTOMIES ON DIFFERENT PANCREATIC STUMP CLOSURE TECHNIQUES |
| title_short | THE DEPENDENCE OF DIRECT RESULTS OF DISTAL PANCREATECTOMIES ON DIFFERENT PANCREATIC STUMP CLOSURE TECHNIQUES |
| title_sort | dependence of direct results of distal pancreatectomies on different pancreatic stump closure techniques |
| topic | pancreas distal pancreatectomy corporocaudal pancreatectomy pancreatic tumors postoperative pancreatic fistula |
| url | https://www.vestnik-grekova.ru/jour/article/view/983 |
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