Central pancreatectomy with external drainage of monolayer pancreaticojejunostomy for prevention of postoperative pancreatic fistula: A retrospective cohort study. (March 2018)

• Record Type: Journal Article
• Authors: Yang, Feng; Jin, Chen; Di, Yang; He, Hang; Hao, Sijie; Yao, Lie; Li, Ji; Fu, Deliang
• Is Part Of: International journal of surgery. Volume 51(2018)
• Page Start: 104
• Page End: 108
• Publication Date: 2018-03
• Subjects: Central pancreatectomy -- Pancreaticojejunostomy -- External drainage -- Stapler closure -- Pancreatic fistula; Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; 617.005
• DOI: 10.1016/j.ijsu.2018.01.009
• Languages: English
• ISSNs: 1743-9191

Abstract

Abstract: Objective: Postoperative pancreatic fistula (POPF) remains a common problem and leading cause of morbidity and mortality after central pancreatectomy (CP). The aim of this study was to present a technique of external drainage of monolayer pancreaticojejunostomy for prevention of POPF. Methods: Patients received elective CP with external drainage of monolayer pancreaticojejunostomy between January 2010 and December 2016 were retrospectively analyzed. The occurrence and severity of POPF, overall complications, reoperation rate, in-hospital mortality, and length of postoperative hospital stay were measured. The 2016 updated definition and classification system of the International Study Group of Pancreatic Surgery (ISGPS) was used for POPF. In addition, a matched-pairs comparison with internal drainage of pancreaticojejunostomy was made. Results: 33 consecutive patients underwent CP with external drainage of monolayer pancreaticojejunostomy during this period. 4 (12.1%) cases developed grade B POPF, among which one patient was classified as having Clavien-Dindo classification IIIa complication. None of the patients developed grade C POPF, delayed gastric emptying, or postpancreatectomy hemorrhage. There was no reoperation or in-hospital mortality occurred. Matched-pairs comparison revealed that patients with external drainage of pancreaticojejunostomy had significantly lower incidence of POPF. Conclusion: External drainage of monolayer pancreaticojejunostomy seems effective in prevention of POPF after CP. Highlights: Postoperative pancreatic fistula (POPF) is a major deterrent to the widespread acceptance of central pancreatectomy (CP). External pancreatic duct stent during CP reduced POPF, although it did not impact biochemical leak. External drainage of monolayer pancreaticojejunostomy is easy and applicable to all kinds of pancreatic remnants.