الفهرس 
Diabetic Peripheral NeuropathyOnly 14 pages are availabe for public view
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Abstract
ABSTRACT
Background: Distal pancreatectomy (DP), performed for removing pancreatic lesions located to the left of the superior mesenteric vein, accounts for approximately 25% of all pancreatic resections. Most recently reported overall mortality rate of DP is less than 3%. However, albeit technically simpler to perform than pancreaticoduodenectomy, morbidity rate of DP remains substantial. Postoperative pancreatic fistulas (POPFs), which may result in numerous clinically significant and potentially life-threatening complications such as intra-abdominal abscess and hemorrhage and surgical site infection, is the leading cause of morbidity after DP, with an incidence of approximately 30-60%. Risk factors associated with POPFs after DP include decreased serum albumin levels, concurrent splenectomy, increased body weight, increased duration of surgery, higher American Society of Anesthesiologists score, and impaired renal function. Furthermore, POPFs often translate to significant increases in hospitalization costs.
Objective: To compare the technique of distal pancreatectomy stump closure in 2 groups of patients; A group underwent stump closure with linear stapling technique and the other group underwent stump closure with continuous suturing technique.
Methods: This was a retrospective-prospective clinical trial that was conducted at General Surgery Department, Ain Shams University Hospitals on 30 Patients who were admitted to specialized hepatobiliary units in Cairo, Egypt for open distal pancreatectomy. Between January 2020 and June 2022 with post-operative follow-up period of 2 months. In our study, there were 30 patients (15 in continuous suturing technique group and 15 in linear stapling technique group) with a mean age of 45.37 ± 10.662 years. Groups were similar in demographic and clinical characteristics (p>0.05).
Results:
• In our study (6.66 %) patients in continuous suturing technique group developed POPF, whereas (33.33%) patients in stapling technique group develop POPF (p=0.169).
• The amount of the blood loss which was found to be statistically significant as the P-Value was found < 0.05 and the T-test was found to be -2.396 which mean that the amount of the blood lost was more in the stapler group.
• There was no statistically significant difference in the rate of pancreatic fistula with suture closure compared with stapler closure (6.66% versus 33.33%).
• There was no statistically significant difference in the risk of intra-abdominal abscess.
• There were 3 patients (20%) with a biochemical leak in continuous suturing technique Group. In stapling technique Group, 4 patients (26.66%) developed biochemical leaks. There was no significant in difference between groups in terms of biochemical leak.
• In our study, mortality rates did not differ between stapler and suture closure techniques.
Conclusion:
Our study showed no significant difference between suture and stapler closure of distal pancreatectomy stump closure with respect to POPF or intra-abdominal collection after DP
The amount of the blood lost was more in the stapler group.
Though there is no suggested superiority of a technique of closure over the other. It is tempting to speculate that the perfection of a technique at each individual institution is just as important as the actual technique applied.