Nonclosure technique with saline-coupled bipolar electrocautery in management of the cut surface after distal pancreatectomy

フォーマット:

論文

責任表示:

Kitagawa, Hirohisa ; Ohta, Tetsuo ; Tani, Takashi ; Tajima, Hidehiro ; Nakagawara, Hisatoshi ; Ohnishi, Ichiro ; Takamura, Hiroyuki ; Kayahara, Masato

言語:

英語

出版情報:

Springer Verlag, 2008-08-01

著者名:

Kitagawa, Hirohisa

Ohta, Tetsuo

Tani, Takashi

Tajima, Hidehiro

Nakagawara, Hisatoshi

Ohnishi, Ichiro

Takamura, Hiroyuki

Kayahara, Masato

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掲載情報:

Journal of Hepato-Biliary-Pancreatic Surgery

ISSN:

0944-1166      

巻:

15

通号:

4

開始ページ:

377

終了ページ:

383

バージョン:

author

概要:

金沢大学医学部附属病院肝胆膵・移植外科　<br />Background/Purpose: Management of the pancreatic remnant after distal pancreatectomy is still debated, the most serious complication is development of a pancreatic fistula. We developed a nonclosure technique … with saline-coupled bipolar electrocautery for preventing fistula formation after distal pancreatectomy as an alternative to traditional stump closure methods. Methods: The distinguishing feature of this technique is nonclosure of the stump, relying instead upon dependable ligation of the main pancreatic duct and sealing of the cut surface by shrinkage accomplished by low-temperature coagulation using saline-coupled bipolar electrocautery. A recent addition has been intraoperative stenting of the remnant pancreatic duct. Results: To date we have used the nonclosure technique in 40 cases, among which 5 (12.5%) developed fistulas: 4 in the nonstenting subgroup (14.8%) and 1 in the stenting subgroup (7.7%). According to a recent classification, 4 fistulas were considered grade A; 1, grade B; and 0, grade C. The grade B patient did not undergo stenting. Conclusion: Our preliminary experience should prompt more widespread evaluation of the nonclosure technique. © Springer Japan 2008. 続きを見る

URL:

http://hdl.handle.net/2297/19571