Katsura N, Kawai Y, Gomi T, Okumura K, Hoashi T, Fukuda S, Takebayashi K, Shimizu K, Satoh M. Preventing pancreatic fistula after distal pancreatectomy: An invagination method. World J Gastroenterol 2017; 23(8): 1507-1512 [PMID: 28293098 DOI: 10.3748/wjg.v23.i8.1507]
Corresponding Author of This Article
Nagato Katsura, MD, PhD, Department of Surgery, Misugikai Otokoyama Hospital, 19, Kazuha Avenue, Otokoyama Izumi, Yawata, Kyoto 614-8366, Japan. n-katsura@takedahp.or.jp
Research Domain of This Article
Surgery
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Nagato Katsura, Takahiko Hoashi, Seijun Fukuda, Kenji Shimizu, Department of Surgery, Misugikai Otokoyama Hospital, Otokoyama Izumi, Yawata, Kyoto 614-8366, Japan
Yasuhiro Kawai, Takashi Gomi, Kenji Okumura, Katsushi Takebayashi, Masugi Satoh, Department of Surgery, Misugikai Satoh Hospital, Yobuhigashimachi Hirakata, Osaka 573-1124, Japan
Author contributions: Katsura N contributed to drafting the manuscript; Kawai Y contributed to performing the operation; and all authors read and approved the final manuscript.
Institutional review board statement: This study was approved by the Ethical Review Board of the Misugikai Otokoyama Hospital (approval number: 2012-01).
Informed consent statement: The patient gave informed consent for the procedure.
Conflict-of-interest statement: All the authors have no conflicts of interest to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Nagato Katsura, MD, PhD, Department of Surgery, Misugikai Otokoyama Hospital, 19, Kazuha Avenue, Otokoyama Izumi, Yawata, Kyoto 614-8366, Japan. n-katsura@takedahp.or.jp
Telephone: +81-75-9830001 Fax: +81-75-9711082
Received: November 2, 2016 Peer-review started: November 4, 2016 First decision: December 2, 2016 Revised: December 15, 2016 Accepted: January 4, 2017 Article in press: January 4, 2017 Published online: February 28, 2017 Processing time: 115 Days and 23.6 Hours
Abstract
Following an increase in the use of the GIA stapler for treating a pancreatic stump, more techniques to prevent postoperative pancreatic juice leakage have been required. We describe one successful case using our new technique of invaginating the cut end of the pancreas into the stomach to prevent a pancreatic fistula (PF) from occurring. A 50-year-old woman with pancreatic cancer in the tail of the pancreas underwent distal pancreatectomy, causing a grade A PF. We resected the distal pancreas without additional reinforcement to invaginate the stump into the gastric posterior wall with single layer anastomosis using a 3-0 absorbable suture. The drain tubes were removed on the third postoperative day. Although a grade A PF was noted, the patient was discharged on foot on the eleventh postoperative day. Our technique may be a suitable method for patients with a pancreatic body and tail tumor.
Core tip: More techniques for preventing postoperative pancreatic juice leakage have been required since the use of GIA stapler has increased. We describe one successful case wherein our new technique of invaginating the cut end of the pancreas into the stomach was used to prevent a pancreatic fistula (PF) from occurring. A 50-year-old woman with pancreatic cancer in the tail of the pancreas underwent distal pancreatectomy. Although a grade A PF was noted, the patient was discharged on foot on the eleventh postoperative day. Our technique may be a suitable method for patients with a pancreatic body and tail tumor.
