Abstract | PURPOSE: To evaluate the outcomes of totally laparoscopic distal pancreatectomy (LDP). METHODS: A prospective database of patients treated within a single institution was studied retrospectively. Between March 2003 and January 2010, 15 patients underwent pancreatic transection with the use of a stapler, followed by sealing of the pancreatic stump with fibrin-coated collagen fleece ( TachoComb) in LDP. RESULTS: LDP was completed successfully in all 15 patients. The median operating time and blood loss were 168 min (range 105-213 min) and 36 ml (range 12-89 ml), respectively. The median drain amylase level peaked at 969 IU/l (93-3077 IU/l) on postoperative day (POD) 1, and then dropped to 165 IU/ l (30-846 IU/l) on POD 3. The median hospital stay was 7 days (range 4-15 days). Biochemical pancreatic leaks developed in three patients (20 %), but there was no clinical pancreatic fistula or postoperative hemorrhage. CONCLUSIONS: Our study shows that the combined use of a stapler and TachoComb decreased the incidence of pancreatic fistulas after LDP. This procedure offers more efficient and consistent results than those achieved by closing the pancreatic stump by stapling alone.
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Authors | Hirokatsu Katagiri, Akira Sasaki, Hiroyuki Nitta, Takeshi Takahara, Satoshi Nishizuka, Go Wakabayashi |
Journal | Surgery today
(Surg Today)
Vol. 42
Issue 10
Pg. 940-4
(Oct 2012)
ISSN: 1436-2813 [Electronic] Japan |
PMID | 22790708
(Publication Type: Evaluation Study, Journal Article)
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Chemical References |
- Drug Combinations
- Tissue Adhesives
- tachocomb
- Fibrinogen
- Aprotinin
- Thrombin
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Topics |
- Adult
- Aged
- Aprotinin
(administration & dosage)
- Drug Combinations
- Female
- Fibrinogen
(administration & dosage)
- Humans
- Laparoscopy
- Male
- Middle Aged
- Pancreatectomy
(instrumentation, methods)
- Pancreatic Diseases
(surgery)
- Pancreatic Fistula
(etiology, prevention & control)
- Postoperative Complications
(prevention & control)
- Retrospective Studies
- Surgical Staplers
- Surgical Stapling
(instrumentation, methods)
- Thrombin
(administration & dosage)
- Tissue Adhesives
(administration & dosage)
- Treatment Outcome
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