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タイトル: Nonclosure technique with saline-coupled bipolar electrocautery in management of the cut surface after distal pancreatectomy
著者: Kitagawa, Hirohisa
Ohta, Tetsuo link image link image
Tani, Takashi
Tajima, Hidehiro
Nakagawara, Hisatoshi
Ohnishi, Ichiro
Takamura, Hiroyuki link image link image
Kayahara, Masato
北川, 裕久
太田, 哲生
谷, 卓
大西, 一朗
高村, 博之
萱原, 正都
発行日: 2008年 8月 1日
出版社(者): Springer Verlag
雑誌名: Journal of Hepato-Biliary-Pancreatic Surgery
ISSN: 0944-1166
巻: 15
号: 4
開始ページ: 377
終了ページ: 383
キーワード: Distal pancreatectomy
Nonclosure technique
Pancreatic fistula
Pancreatic stent
Saline-coupled bipolar electrocautery
抄録: 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.
DOI: 10.1007/s00534-008-1332-z
URI: http://hdl.handle.net/2297/19571
資料種別: Journal Article
版表示: author
出現コレクション:1. 査読済論文

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