Abstract: Objective:To investigate the efficacy of wrapping and suturing of pancreatic stump with the avascular zone of the transverse mesocolon for preventing pancreatic leakage after distal pancreatectomy.
Methods The clinical data of 69 patients who received distal pancreatectomy at the Affiliated Tumor Hospital of Zhengzhou University from May 2011 to March 2014 were retrospectively analyzed. The pancreatic stump was wrapped with the avascular zone of the transverse mesocolon after suturing the pancreatic stump in 34 patients (the modified group), and the pancreatic stump of 34 patients was sutured without any other treatment (the control group). The time for pancreatic stump management, complications, time for drainage tube placement and duration of postoperative hospital stay of the 2 groups were compared. Patients were followed up through outpatient examination and telephone interview till June 2014. The measurement data and the count data were analyzed using the t test and the chi square test, respectively.
Results:The time for pancreatic stump management of the modified group and the control group were (15.2±2.1)minutes and (13.2±3.2)minutes, with no significant difference between the 2 groups ( t=1.565, P>0.05). No patient was complicated with other diseases in the modified group, while 9 patients in the control group was complicated with pancreatic fistula, with significant differences between the 2 groups ( χ 2 =9.399, P<0.05). The time for drainage tube placement of the modified group and the control group were (6.1±2.2)days and (16.6±3.5)days, the duration of postoperative hospital stay were (12.5± 2.5)days and (21.5±3.5)days, with significant difference between the 2 groups ( t= -11.902,-9.853, P<0.05). Sixty three patients were followed up from 1 to 35 months with a mean time of 15 months. Fifteen patients died, and the condition of other patients was normal.
Conclusion: Wrapping and suturing of the pancreatic stump with the avascular zone of the transverse mesocolon is effective for preventing the pancreatic leakage after distal pancreatectomy and shortens the time of postoperative hospital stay.