A simple and safe pancreas transection using a stapling device for a distal pancreatectomy

Area of Science:

• Surgical Oncology
• Gastroenterology
• Medical Devices

Background:

• Pancreatic fistula is a common complication following distal pancreatectomy.
• The optimal method for pancreatic stump closure remains debated.
• Existing techniques include suture and stapler closures, each with varying efficacy.

Purpose of the Study:

• To evaluate the effectiveness of stapler closure versus suture closure for pancreatic stumps after distal pancreatectomy.
• To compare the incidence of pancreatic fistulas between different closure methods.
• To assess the impact of stapler devices on postoperative hospital stay.

Main Methods:

• Retrospective review of 36 patients undergoing distal pancreatectomy between 2000 and 2007.
• Patients were categorized into suture closure (11 patients) and stapler closure (24 patients) groups.
• A subset of 7 patients in the stapler group utilized the Echelon 60 stapler.

Main Results:

• The overall pancreatic fistula rate was 17% (6/36).
• Stapler closure resulted in a lower fistula rate (12%, 3/24) compared to suture closure (27%, 3/11).
• Patients treated with the Echelon 60 stapler had no fistulas and a significantly shorter hospital stay.

Conclusions:

• Stapler closure of the pancreatic stump is advantageous in distal pancreatectomy.
• The Echelon 60 stapler demonstrates superior safety and efficacy, reducing fistula rates and hospital stay.
• Stapler closure offers a simple, safe alternative to traditional suture techniques.