Shorter Drainage Tube to the Pancreatic Stump Reduces Pancreatic Fistula After Distal Pancreatectomy.

IF 1.1 4区医学 Q3 SURGERY

Surgical Laparoscopy, Endoscopy & Percutaneous Techniques Pub Date : 2024-12-01 DOI:10.1097/SLE.0000000000001318

Tomoyuki Nagaoka, Katsunori Sakamoto, Kohei Ogawa, Takahiro Hikida, Chihiro Ito, Miku Iwata, Akimasa Sakamoto, Mikiya Shine, Yusuke Nishi, Mio Uraoka, Masahiko Honjo, Kei Tamura, Yasutsugu Takada

{"title":"Shorter Drainage Tube to the Pancreatic Stump Reduces Pancreatic Fistula After Distal Pancreatectomy.","authors":"Tomoyuki Nagaoka, Katsunori Sakamoto, Kohei Ogawa, Takahiro Hikida, Chihiro Ito, Miku Iwata, Akimasa Sakamoto, Mikiya Shine, Yusuke Nishi, Mio Uraoka, Masahiko Honjo, Kei Tamura, Yasutsugu Takada","doi":"10.1097/SLE.0000000000001318","DOIUrl":null,"url":null,"abstract":"Background: We investigated the relationship between the length of a prophylactic closed-suction drainage tube and clinically relevant postoperative pancreatic fistula (CR-POPF) in distal pancreatectomy (DP).Materials and methods: The clinical data of 76 patients who underwent DP using a reinforced stapler for the division of the pancreas at Ehime University Hospital between December 2017 and May 2023 were retrospectively analyzed. Laparoscopic DP was performed in 41 patients (53.9%). Closed-suction drainage was performed using a 19 Fr ExuFlow Round Drain with a vacuum bulb. The drainage tube length was defined as the distance between the peripancreatic stump site and the abdominal wall insertion site using abdominal radiography.Results: CR-POPF was observed in 12 patients (15.8%). Univariate analyses demonstrated that male sex ( P =0.020), American Society of Anesthesiologists Physical Status ( P =0.017), current smoking ( P =0.005), and drainage tube length ( P <0.001) were significantly associated with CR-POPF. The optimal cut-off value of drainage tube length for CR-POPF was 220 mm (area under the receiver operating characteristic curve=0.80). In multivariate analyses, drainage tube length (≥220 mm) was the sole independent predictor for CR-POPF (odds ratio, 6.59; P =0.023). According to computed tomography performed ∼1 week after surgery, the median volume of peripancreatic fluid collection was significantly higher in the long drainage tube group than in the short drainage tube group ( P <0.001).Conclusion: A drainage tube inserted at a shorter distance to the pancreatic stump may reduce the incidence of CR-POPF after DP.","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":"571-577"},"PeriodicalIF":1.1000,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/SLE.0000000000001318","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"SURGERY","Score":null,"Total":0}

引用次数: 0

Abstract

Background: We investigated the relationship between the length of a prophylactic closed-suction drainage tube and clinically relevant postoperative pancreatic fistula (CR-POPF) in distal pancreatectomy (DP).

Materials and methods: The clinical data of 76 patients who underwent DP using a reinforced stapler for the division of the pancreas at Ehime University Hospital between December 2017 and May 2023 were retrospectively analyzed. Laparoscopic DP was performed in 41 patients (53.9%). Closed-suction drainage was performed using a 19 Fr ExuFlow Round Drain with a vacuum bulb. The drainage tube length was defined as the distance between the peripancreatic stump site and the abdominal wall insertion site using abdominal radiography.

Results: CR-POPF was observed in 12 patients (15.8%). Univariate analyses demonstrated that male sex ( P =0.020), American Society of Anesthesiologists Physical Status ( P =0.017), current smoking ( P =0.005), and drainage tube length ( P <0.001) were significantly associated with CR-POPF. The optimal cut-off value of drainage tube length for CR-POPF was 220 mm (area under the receiver operating characteristic curve=0.80). In multivariate analyses, drainage tube length (≥220 mm) was the sole independent predictor for CR-POPF (odds ratio, 6.59; P =0.023). According to computed tomography performed ∼1 week after surgery, the median volume of peripancreatic fluid collection was significantly higher in the long drainage tube group than in the short drainage tube group ( P <0.001).

Conclusion: A drainage tube inserted at a shorter distance to the pancreatic stump may reduce the incidence of CR-POPF after DP.

查看原文本刊更多论文

胰腺残端较短的引流管可减少胰腺远端切除术后的胰腺瘘。

背景：我们研究了预防性闭式吸引引流管的长度与胰腺远端切除术（DP）术后胰瘘（CR-POPF）临床相关性之间的关系：回顾性分析了2017年12月至2023年5月期间在爱媛大学医院使用加强型订书机进行胰腺分割DP的76例患者的临床数据。41名患者（53.9%）接受了腹腔镜胰腺分割术。闭式抽吸引流是使用带真空球的 19 Fr ExuFlow 圆形引流管进行的。引流管长度的定义是使用腹部放射线检查胰周残端部位与腹壁插入部位之间的距离：结果：12 名患者（15.8%）出现 CR-POPF。单变量分析表明，男性性别（P=0.020）、美国麻醉医师协会体格状态（P=0.017）、目前吸烟（P=0.005）和引流管长度（PC结论：引流管插入距离较短时，胰周残端部位与腹壁插入部位之间的距离较长：在距离胰腺残端较短的位置插入引流管可降低 DP 后 CR-POPF 的发生率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Surgical Laparoscopy, Endoscopy & Percutaneous Techniques 医学-外科

CiteScore

2.00

自引率

10.00%

发文量

103

审稿时长

3-8 weeks

期刊介绍： Surgical Laparoscopy Endoscopy & Percutaneous Techniques is a primary source for peer-reviewed, original articles on the newest techniques and applications in operative laparoscopy and endoscopy. Its Editorial Board includes many of the surgeons who pioneered the use of these revolutionary techniques. The journal provides complete, timely, accurate, practical coverage of laparoscopic and endoscopic techniques and procedures; current clinical and basic science research; preoperative and postoperative patient management; complications in laparoscopic and endoscopic surgery; and new developments in instrumentation and technology.