The effect of mesh reinforcement of a stapled transection line on the rate of pancreatic occlusion failure after distal pancreatectomy

Review of a single institution's experience

Fabian Mc Johnston, Antonino Cavataio, Steven M. Strasberg, Nicholas A. Hamilton, Peter O. Simon, Kathryn Trinkaus, M. B Majella Doyle, Brent D. Mathews, Matthew R. Porembka, David C. Linehan, William G. Hawkins

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Background: Pancreatic occlusion failure (POF) after distal pancreatectomy remains a common source of morbidity. Here, we review our experience with distal pancreatectomy and attempt to identify factors which influence POF rates. Patients and Methods: One hundred sixty-nine distal pancreatectomies were performed between 2002 and 2007. Review of the computerized medical records and physician office records was performed for all patients. Univariate and multivariate analyses were performed to determine factors which might influence the incidence of POF. The data set was analysed for factors which might influence the pancreatic occlusion rate. Analysis included patient and disease characteristics including: age, gender, body mass index (BMI), diagnosis, consistency of the pancreas and history of pancreatitis, as well as intra-operative variables including: surgeon, absorbable mesh reinforcement and operative approach. Results: POF was the most common peri-operative complication. POF was identified in 32 out of 169 patients (19%). Transection technique (hand sewn, stapled, stapled with mesh) and procedure complexity were factors associated with differences in POF rates by both univariate and multivariate analyses. POF was identified in 7 out of 70 patients (10%) when an absorbable mesh was utilized, and 25 of 99 patients (25%) when mesh was not utilized (P < 0.02). Discussion: These data suggest that a randomized controlled trial will be required to determine if mesh reinforcement reduces the rate and severity of POF after distal pancreatectomy.

Original languageEnglish (US)
Pages (from-to)25-31
Number of pages7
JournalHPB
Volume11
Issue number1
DOIs
StatePublished - 2009

Fingerprint

Pancreatectomy
Multivariate Analysis
Computerized Medical Records Systems
Physicians' Offices
Pancreatitis
Pancreas
Body Mass Index
Randomized Controlled Trials
Hand
Morbidity
Incidence

Keywords

  • Distal pancreatectomy
  • Mesh reinforcement
  • Pancreatic fistula
  • Pancreatic leak

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology

Cite this

The effect of mesh reinforcement of a stapled transection line on the rate of pancreatic occlusion failure after distal pancreatectomy : Review of a single institution's experience. / Johnston, Fabian Mc; Cavataio, Antonino; Strasberg, Steven M.; Hamilton, Nicholas A.; Simon, Peter O.; Trinkaus, Kathryn; Doyle, M. B Majella; Mathews, Brent D.; Porembka, Matthew R.; Linehan, David C.; Hawkins, William G.

In: HPB, Vol. 11, No. 1, 2009, p. 25-31.

Research output: Contribution to journalArticle

Johnston, FM, Cavataio, A, Strasberg, SM, Hamilton, NA, Simon, PO, Trinkaus, K, Doyle, MBM, Mathews, BD, Porembka, MR, Linehan, DC & Hawkins, WG 2009, 'The effect of mesh reinforcement of a stapled transection line on the rate of pancreatic occlusion failure after distal pancreatectomy: Review of a single institution's experience', HPB, vol. 11, no. 1, pp. 25-31. https://doi.org/10.1111/j.1477-2574.2008.00001.x
Johnston, Fabian Mc ; Cavataio, Antonino ; Strasberg, Steven M. ; Hamilton, Nicholas A. ; Simon, Peter O. ; Trinkaus, Kathryn ; Doyle, M. B Majella ; Mathews, Brent D. ; Porembka, Matthew R. ; Linehan, David C. ; Hawkins, William G. / The effect of mesh reinforcement of a stapled transection line on the rate of pancreatic occlusion failure after distal pancreatectomy : Review of a single institution's experience. In: HPB. 2009 ; Vol. 11, No. 1. pp. 25-31.
@article{f1b1e1f50f8d4b189fce618304f55df8,
title = "The effect of mesh reinforcement of a stapled transection line on the rate of pancreatic occlusion failure after distal pancreatectomy: Review of a single institution's experience",
abstract = "Background: Pancreatic occlusion failure (POF) after distal pancreatectomy remains a common source of morbidity. Here, we review our experience with distal pancreatectomy and attempt to identify factors which influence POF rates. Patients and Methods: One hundred sixty-nine distal pancreatectomies were performed between 2002 and 2007. Review of the computerized medical records and physician office records was performed for all patients. Univariate and multivariate analyses were performed to determine factors which might influence the incidence of POF. The data set was analysed for factors which might influence the pancreatic occlusion rate. Analysis included patient and disease characteristics including: age, gender, body mass index (BMI), diagnosis, consistency of the pancreas and history of pancreatitis, as well as intra-operative variables including: surgeon, absorbable mesh reinforcement and operative approach. Results: POF was the most common peri-operative complication. POF was identified in 32 out of 169 patients (19{\%}). Transection technique (hand sewn, stapled, stapled with mesh) and procedure complexity were factors associated with differences in POF rates by both univariate and multivariate analyses. POF was identified in 7 out of 70 patients (10{\%}) when an absorbable mesh was utilized, and 25 of 99 patients (25{\%}) when mesh was not utilized (P < 0.02). Discussion: These data suggest that a randomized controlled trial will be required to determine if mesh reinforcement reduces the rate and severity of POF after distal pancreatectomy.",
keywords = "Distal pancreatectomy, Mesh reinforcement, Pancreatic fistula, Pancreatic leak",
author = "Johnston, {Fabian Mc} and Antonino Cavataio and Strasberg, {Steven M.} and Hamilton, {Nicholas A.} and Simon, {Peter O.} and Kathryn Trinkaus and Doyle, {M. B Majella} and Mathews, {Brent D.} and Porembka, {Matthew R.} and Linehan, {David C.} and Hawkins, {William G.}",
year = "2009",
doi = "10.1111/j.1477-2574.2008.00001.x",
language = "English (US)",
volume = "11",
pages = "25--31",
journal = "HPB",
issn = "1365-182X",
publisher = "John Wiley and Sons Inc.",
number = "1",

}

TY - JOUR

T1 - The effect of mesh reinforcement of a stapled transection line on the rate of pancreatic occlusion failure after distal pancreatectomy

T2 - Review of a single institution's experience

AU - Johnston, Fabian Mc

AU - Cavataio, Antonino

AU - Strasberg, Steven M.

AU - Hamilton, Nicholas A.

AU - Simon, Peter O.

AU - Trinkaus, Kathryn

AU - Doyle, M. B Majella

AU - Mathews, Brent D.

AU - Porembka, Matthew R.

AU - Linehan, David C.

AU - Hawkins, William G.

PY - 2009

Y1 - 2009

N2 - Background: Pancreatic occlusion failure (POF) after distal pancreatectomy remains a common source of morbidity. Here, we review our experience with distal pancreatectomy and attempt to identify factors which influence POF rates. Patients and Methods: One hundred sixty-nine distal pancreatectomies were performed between 2002 and 2007. Review of the computerized medical records and physician office records was performed for all patients. Univariate and multivariate analyses were performed to determine factors which might influence the incidence of POF. The data set was analysed for factors which might influence the pancreatic occlusion rate. Analysis included patient and disease characteristics including: age, gender, body mass index (BMI), diagnosis, consistency of the pancreas and history of pancreatitis, as well as intra-operative variables including: surgeon, absorbable mesh reinforcement and operative approach. Results: POF was the most common peri-operative complication. POF was identified in 32 out of 169 patients (19%). Transection technique (hand sewn, stapled, stapled with mesh) and procedure complexity were factors associated with differences in POF rates by both univariate and multivariate analyses. POF was identified in 7 out of 70 patients (10%) when an absorbable mesh was utilized, and 25 of 99 patients (25%) when mesh was not utilized (P < 0.02). Discussion: These data suggest that a randomized controlled trial will be required to determine if mesh reinforcement reduces the rate and severity of POF after distal pancreatectomy.

AB - Background: Pancreatic occlusion failure (POF) after distal pancreatectomy remains a common source of morbidity. Here, we review our experience with distal pancreatectomy and attempt to identify factors which influence POF rates. Patients and Methods: One hundred sixty-nine distal pancreatectomies were performed between 2002 and 2007. Review of the computerized medical records and physician office records was performed for all patients. Univariate and multivariate analyses were performed to determine factors which might influence the incidence of POF. The data set was analysed for factors which might influence the pancreatic occlusion rate. Analysis included patient and disease characteristics including: age, gender, body mass index (BMI), diagnosis, consistency of the pancreas and history of pancreatitis, as well as intra-operative variables including: surgeon, absorbable mesh reinforcement and operative approach. Results: POF was the most common peri-operative complication. POF was identified in 32 out of 169 patients (19%). Transection technique (hand sewn, stapled, stapled with mesh) and procedure complexity were factors associated with differences in POF rates by both univariate and multivariate analyses. POF was identified in 7 out of 70 patients (10%) when an absorbable mesh was utilized, and 25 of 99 patients (25%) when mesh was not utilized (P < 0.02). Discussion: These data suggest that a randomized controlled trial will be required to determine if mesh reinforcement reduces the rate and severity of POF after distal pancreatectomy.

KW - Distal pancreatectomy

KW - Mesh reinforcement

KW - Pancreatic fistula

KW - Pancreatic leak

UR - http://www.scopus.com/inward/record.url?scp=65749088066&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=65749088066&partnerID=8YFLogxK

U2 - 10.1111/j.1477-2574.2008.00001.x

DO - 10.1111/j.1477-2574.2008.00001.x

M3 - Article

VL - 11

SP - 25

EP - 31

JO - HPB

JF - HPB

SN - 1365-182X

IS - 1

ER -