A phase II trial of lanreotide for the prevention of postoperative pancreatic fistula

Pillarisetty, Venu G.; Abbasi, Arezou; Park, James O.; Sham, Jonathan G.

doi:10.1016/j.hpb.2022.07.011

Cited by 5 publications

(1 citation statement)

References 17 publications

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“…While the efficacy of sealants or of an omental roll-up in preventing postoperative morbidity is still a matter of debate [18][19][20], the use of external drainage of the pancreatic duct showed improved rates of CR-POPF [21][22][23]. Moreover, contrasting results concerning POPF have been achieved using somatostatin analogs [6,24,25].…”

Section: Introductionmentioning

confidence: 99%

Single Center, Propensity Score Matching Analysis of Different Reconstruction Techniques following Pancreatoduodenectomy

Bellotti

Cardini

Strolz

et al. 2023

JCM

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Background: Pancreatoduodenectomy is still hampered by significant morbidity. So far, there is no universally accepted technique aimed at minimizing postoperative complications. Herein, we compare three different reconstruction techniques. Methods: This is a retrospective study of a prospectively maintained database including 283 patients operated between January 2010 and December 2020. Three reconstruction techniques were compared: (1) the Neuhaus-style telescope pancreatojejunostomy, (2) the pancreatogastrostomy, and (3) the modified Blumgart-style, duct-to-mucosa pancreatojejunostomy. The primary endpoint consisted in determining the rates of clinically relevant postoperative pancreatic fistulas (CR-POPF); the secondary endpoints included 90 days morbidity and mortality rates. A propensity score matching analysis was used. Results: Rates of CR-POPF did not differ significantly between the groups (Neuhaus-style pancreatojejunostomy 16%, pancreatogastrostomy 17%, modified Blumgart-style pancreatojejunostomy 15%), neither in the unmatched nor in the matched analysis (p = 0.993 and p = 0.901, respectively). Similarly, no significant differences could be observed with regard to major morbidity (unmatched p = 0.596, matched p = 0.188) and mortality rates (unmatched p = 0.371, matched p = 0.209) within the first 90 days following surgery. Propensity-score matching analyses revealed, however, a higher occurrence of post-pancreatectomy hemorrhage after pancreatogastrostomy (p = 0.015). Conclusion: Similar CR-POPF rates suggest no crucial role of the applied reconstruction technique. Increased incidence of intraluminal post-pancreatectomy hemorrhages following pancreatogastrostomy demands awareness for meticulous hemostasis.

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