Safe closure technique for distal pancreatic resection

Area of Science:

• Gastroenterology
• Surgical Innovation
• Biomaterials in Surgery

Background:

• Distal pancreatic resection traditionally involves closure methods with an average 13% complication rate.
• Previous techniques included mattress sutures with duct ligation and stainless steel stapling.
• Complication rates ranged from 6% to 30% across various management strategies.

Purpose of the Study:

• To evaluate the efficacy and safety of absorbable lactomer staples for pancreatic stump closure post-distal resection.
• To reduce postoperative complications associated with pancreatic transection management.
• To present a novel surgical approach using Polysorb (Auto Suture) staples.

Main Methods:

• A 10-year retrospective study involving 90 patients undergoing distal pancreatic resection.
• Closure of pancreatic transection surfaces was performed using absorbable lactomer clips.
• Indications included necrosis, fistulas, abscesses, pseudocysts, trauma, pancreatitis, and tumors.

Main Results:

• No postoperative complications such as pancreatic fistula, abscess, or bleeding were observed in the study cohort.
• Zero morbidity and mortality were recorded during the 6-12 month follow-up period.
• One patient developed a pseudocyst 6 months post-surgery, successfully treated with cysto-jejunostomy.

Conclusions:

• Absorbable lactomer staples provide a safe and effective alternative for managing the pancreatic transection margin.
• This technique is suitable for all distal pancreatic resections, including those for benign, malignant, or traumatic conditions.
• The use of these staples minimizes the risk of postoperative complications, enhancing patient outcomes.