Transection using bipolar scissors reduces pancreatic fistula after distal pancreatectomy
Transection using bipolar scissors reduces pancreatic fistula after distal pancreatectomy
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DOI：
10.1007/s00534-008-1330-1
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发表时间：
2008-07-01
期刊：
影响因子：
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通讯作者：
Yamaue, Hiroki
中科院分区：
文献类型：
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作者：
Kawai, Manabu;Tani, Masaji;Yamaue, Hiroki
背景/目的。各种方法和技术处理残胰的手术残端已报告，以减少胰尾切除术（DP）后胰瘘。然而，DP后适当的手术残端闭合仍有争议。我们的目的是为了阐明在DP中使用双极剪是否比手工缝合手术残端闭合减少胰瘘。在1989年1月至2005年12月期间，对手术残端进行了手工缝合缝合（n = 49），并在2006年1月至2007年7月期间前瞻性地进行了双极剪缝合（n = 26）。DP后胰瘘的总体发生率为22例患者（29%）。手工缝合组（41%）和双极剪组（8%）在胰瘘方面存在显著差异（P = 0.0164）。多因素Logistic回归分析显示，软胰腺和手工缝合与双极剪相比，是DP术后胰瘘的独立危险因素（P分别为0.011和0.0361）。双极剪是减少DP术后胰瘘的有效器械。
Background/Purpose. Various methods and technique for treating the surgical stump of the remnant pancreas have been reported to reduce pancreatic fistula after distal pancreatectomy (DP). However, appropriate surgical stump closure after DP is still controversial. We aimed to clarify whether using bipolar scissors in DP reduces pancreatic fistula compared to hand-sewn suture of surgical stump closure.Methods. Between January 1989 and December 2005, handsewn suture of surgical stump closure was performed (n = 49), and bipolar scissors was prospectively performed between January 2006 and July 2007 (n = 26).Results. The overall rate of pancreatic fistula after DP was 22 patients (29%). There were significant differences between the hand-sewn suture group (41%) and bipolar scissors group (8%) concerning pancreatic fistula (P = 0.0164). A multivariate logistic regression analysis revealed that two factors, soft pancreas and hand-sewn suture compared to bipolar scissors, were independent risk factors of pancreatic fistula after DP (P = 0.011 and 0.0361, respectively).Conclusions. Bipolar scissors for transection of the pancreas is a useful device to reduce pancreatic fistula after DP.