Vascular Stapler for Transection of Pancreatic Parenchyma in Laparoscopic Distal Pancreatectomy

摘要

Pancreatic fistula (PF) is one of the most frequent and clinically significant postoperative complications after pancreatic surgery, correlated with prolonged hospital stay, increased cost for health-care services, and poorer clinical outcomes, and its rates have been associated with implemented surgical technique, particularly with the method of pancreatic stump (PS) management.1 In open distal pancreatectomy, hand-oversewing of PS is usually a feasible and straight-forward method to secure it, whereas in laparoscopic distal pancreatectomy (LDP), intracorporeal suturing can be quite challenging. Transection of the parenchyma using endoscopic staplers is quite popular among laparoscopic surgeons, but their role in pancreatic transection has not been conclusively studied, and it largely depends on each surgeon's preference whether automatic staplers-alone or in combination with several adjuncts-or other techniques are applied.1 This study presents a single-center experience of 43 consecutive LDPs, all with the use of endoscopic vascular stapler alone for pancreatic transection, with particular focus in PF development and relevant postoperative outcomes. Data were collected in a prospective database of 43 consecutive patients who underwent LDP for treatment of lesions in the body or tail of pancreas.