Roux-en-Y drainage of the pancreatic stump decreases pancreatic fistula after distal pancreatic resection

Wagner, M; Gloor, B; Ambühl, M; Worni, M; Lutz, J A; Angst, E; Candinas, D (2007). Roux-en-Y drainage of the pancreatic stump decreases pancreatic fistula after distal pancreatic resection. Journal of gastrointestinal surgery, 11(3), pp. 303-8. New York, N.Y.: Springer-Verlag 10.1007/s11605-007-0094-2

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Clinically relevant fistula after distal pancreatic resection occurs in 5-30% of patients, prolonging recovery and considerably increasing in-hospital stay and costs. We tested whether routine drainage of the pancreatic stump into a Roux-en-Y limb after distal pancreatic resection decreased the incidence of fistula. From October 2001, data of all patients undergoing pancreatic distal resection were entered in a prospective database. From June 2003 after resection, the main pancreatic duct and the pancreatic stump were oversewn, and in addition, anastomosed into a jejunal Roux-en-Y limb by a single-layer suture (n = 23). A drain was placed near the anastomosis, and all patients received octreotide for 5-7 days postoperatively. The volume of the drained fluid was registered daily, and concentration of amylase was measured and recorded every other day. Patient demographics, hospital stay, pancreatic fistula incidence (> or =30 ml amylase-rich fluid/day on/after postoperative day 10), perioperative morbidity, and follow-up after discharge were compared with our initial series of patients (treated October 2001-May 2003) who underwent oversewing only (n = 20). Indications, patient demographics, blood loss, and tolerance of an oral diet were similar. There were four (20%) pancreatic fistulas in the "oversewn" group and none in the anastomosis group (p < 0.05). Nonsurgical morbidity, in-hospital stay, and follow-up were comparable in both groups.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine > Visceral Surgery

UniBE Contributor:

Wagner, Markus; Gloor, Beat and Candinas, Daniel

ISSN:

1091-255X

ISBN:

17458602

Publisher:

Springer-Verlag

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 14:56

Last Modified:

26 Jun 2018 15:31

Publisher DOI:

10.1007/s11605-007-0094-2

PubMed ID:

17458602

Web of Science ID:

000245949900011

BORIS DOI:

10.7892/boris.24149

URI:

https://boris.unibe.ch/id/eprint/24149 (FactScience: 47130)

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