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The Influence of Thickest triple-row stapler on Pancreatic Fistula After Left Side Pancreatectomy

Kwang Yeol Paik, Won Kyung Kang, Prof. Catholic University of Korea, Yeouido St. Mary’s Hosp

Background: The use of stapling devices for distal pancreatectomy remains controversial, due to concerns about the development of postoperative pancreatic ?stula (POPF). Pancreas thickness might be associated with POPF, but suitable thickness of stapler remains also inconclusive in view of reducing POPF.

Methods: We routinely use thickest Endo GIA™ Reloads with Tri-Staple™ (Covidien, North Haven, CT) for pancreas closure during laparoscopic left side pancreatectomy (LP) since 2013. We compared short term surgical results of the consecutive ten patients underwent LP using new stapler (NS) and 20 patients with LP using other type of stapler (OS) focusing on POPF.

Results: No patients developed clinically relavent (CR)-POPF in NS group and two patients (10.0%) with OS group experienced CR-POPF. However, there was no difference of CR-POPF between two groups. Pancreas thickness on stapling point were not different between two groups (15.9mm vs 18.9mm, p=0.246). In NS group, 3 patients (30.0%) developed a POPF, whereas in OS group, 12 patients (60.0%) developed a POPF. There was also no difference of POPF between 2 groups.

Conclusion: The GIA™ Reloads with the thickest Tri-Staple™ allows effective prevention of CR-POPF after distal pancreatectomy. However, there was no advantage over thinner stapler for LP.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 84725

Program Number: P528

Presentation Session: iPoster Session (Non CME)

Presentation Type: Poster

79

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