Impact of pre-compression versus non-compression before parenchyma transection in left-sided pancreatic resection on the rate of clinically relevant pancreatic fistula: multicentre randomized clinical trial.

IF 8.6 1区 医学 Q1 SURGERY
Tatsuaki Sumiyoshi, Kenichiro Uemura, Shingo Seo, Tsutomu Fujii, Sohei Satoi, Takeshi Miwa, Mina Fukasawa, So Yamaki, Akihiko Oshita, Tomoyuki Abe, Takeshi Sudo, Sho Tazuma, Masaru Sasaki, Yasuhiro Matsugu, Toshihiko Kohashi, Akira Nakashima, Shintaro Kuroda, Koichi Oishi, Masashi Inoue, Keisuke Okano, Hiroyoshi Matsukawa, Hideki Ohdan, Shinya Takahashi
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引用次数: 0

Abstract

Background: Previous retrospective studies have demonstrated the effectiveness of parenchymal pre-compression in reducing pancreatic fistula after left-sided pancreatic resection; however, no multicentre RCT has been conducted. The aim of this study was to investigate whether pre-compression reduces grade B/C pancreatic fistula after left-sided pancreatic resection.

Methods: Between 23 March 2021 and 26 January 2023, patients scheduled for left-sided pancreatic resection were enrolled in a multicentre RCT at 13 hospitals in Japan. These patients were randomly assigned (1 : 1) to the pre-compression group or the non-compression group. The primary endpoint was the incidence of grade B/C pancreatic fistula and the secondary endpoint was it in the subgroup.

Results: Overall, 180 patients were assigned to the pre-compression group and the non-compression group (92 patients and 88 patients respectively) and 171 patients were analysed (88 patients in the pre-compression group and 83 patients in the non-compression group). Grade B/C pancreatic fistula was observed in 22 patients (12.9%), including 11 of 88 patients (12.5%) in the pre-compression group and 11 of 83 patients (13.3%) in the non-compression group (OR 0.94 (95% c.i. 0.38 to 2.31); P = 0.883).

Conclusion: A statistically significant difference in the incidence of grade B/C pancreatic fistula was not observed between the pre-compression group and the non-compression group.

Registration number: UMIN000042700 (https://www.umin.ac.jp).

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来源期刊
CiteScore
12.70
自引率
7.30%
发文量
1102
审稿时长
1.5 months
期刊介绍: The British Journal of Surgery (BJS), incorporating the European Journal of Surgery, stands as Europe's leading peer-reviewed surgical journal. It serves as an invaluable platform for presenting high-quality clinical and laboratory-based research across a wide range of surgical topics. In addition to providing a comprehensive coverage of traditional surgical practices, BJS also showcases emerging areas in the field, such as minimally invasive therapy and interventional radiology. While the journal appeals to general surgeons, it also holds relevance for specialty surgeons and professionals working in closely related fields. By presenting cutting-edge research and advancements, BJS aims to revolutionize the way surgical knowledge is shared and contribute to the ongoing progress of the surgical community.
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