Revisionseingriffe und Interventionen nach Pankreaslinksresektion

Glowka, Tim R.; Webler, M.; Hirner, A.; Kalff, JC; Standop, Jens

doi:10.1055/s-0029-1224742

Cited by 4 publications

(5 citation statements)

References 7 publications

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“…Down this line no difference in the rate of pancreatic fistulas when comparing suture and stapler method or a combination of both could be proven [1,5,6]. …”

Section: Discussionmentioning

confidence: 99%

“…In the last 20 years several studies have focused on distal pancreatectomy, which accounts for up to 10% of all pancreatic resections [5]. The main cause of postoperative morbidity in surgery of the distal pancreas is pancreatic fistulas ( 30% ) [2,4,6,7].…”

Section: Introductionmentioning

confidence: 99%

“…In this context, many different surgical techniques for pancreatic resection and closure of the resection margin were described, such as closure by stapler with or without suture, pancreaticoenteric anastomoses with various modifications, mesh-application, or closure with fibrin glue. None of these techniques were superior concerning the rate of pancreatic fistulas [1,5,6,11]. …”

Section: Introductionmentioning

confidence: 99%

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Is the covering of the resection margin after distal pancreatectomy advantageous?

et al. 2013

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BackgroundIn recent years, many advances in pancreatic surgery have been achieved. Nevertheless, the rate of pancreatic fistula following pancreatic tail resection does not differ between various techniques, still reaching up to 30% in prospective multicentric studies. Taking into account contradictory results concerning the usefulness of covering resection margins after distal pancreatectomy, we sought to perform a systematic, retrospective analysis of patients that underwent distal pancreatectomy at our center.MethodsWe retrospectively analysed the data of 74 patients that underwent distal pancreatectomy between 2001 and 2011 at the community hospital in Neuss. Demographic factors, indications, postoperative complications, surgical or interventional revisions, and length of hospital stay were registered to compare the outcome of patients undergoing distal pancreatectomy with coverage of the resection margins vs. patients undergoing distal pancreatectomy without coverage of the resection margins. Differences between groups were calculated using Fisher’s exact and Mann–Whitney U test.ResultsMain indications for pancreatic surgery were insulinoma (n=18, 24%), ductal adenocarcinoma (n=9, 12%), non-single-insulinoma-pancreatogenic-hypoglycemia-syndrome (NSIPHS) (n=8, 11%), and pancreatic cysts with pancreatitis (n=8, 11%). In 39 of 74 (53%) patients no postoperative complications were noted. In detail we found that 23/42 (55%) patients with coverage vs. 16/32 (50%) without coverage of the resection margins had no postoperative complications. The most common complications were pancreatic fistulas in eleven patients (15%), and postoperative bleeding in nine patients (12%). Pancreatic fistulas occurred in patients without coverage of the resection margins in 7/32 (22%) vs. 4/42 (1011%) with coverage are of the resection margins, yet without reaching statistical significance. Postoperative bleeding ensued with equal frequency in both groups (12% with coverage versus 13% without coverage of the resection margins). The reoperation rate was 8%. The hospital stay for patients without coverage was 13 days (5–60) vs. 17 days (8–60) for patients with coverage.ConclusionsThe results show no significant difference in the fistula rate after covering of the resection margin after distal pancreatectomy, which contributes to the picture of an unsolved problem.

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“…Down this line no difference in the rate of pancreatic fistulas when comparing suture and stapler method or a combination of both could be proven [1,5,6]. …”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Is the covering of the resection margin after distal pancreatectomy advantageous?

et al. 2013

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“…Insbesondere hier steht daher der Chirurg -und im Besonderen der Operateur -einem primär interventionellen Vorgehen zumeist positiv gegenüber. In vielen Fällen lassen sich so aufwendige Reoperationen vermeiden und die Komplikation endoskopisch beherrschen [7,10,16]. …”

Section: Introductionunclassified

Schwindende Fachgrenzen zwischen Viszeralchirurgie und interventioneller Endoskopie

Kalff

Schäfer

2010

Chirurg

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The tremendous increase in medical knowledge over the last decades and technical progress in medicine have caused further professional specialization. Numerous medical fields have evolved through the process of separation from the parent specialization and the traditional distinction between surgical and medical disciplines has been blurred. As a result of this development organ-specific interdisciplinary units have been formed and new partners have united, such as surgeons and gastroenterologists in the field of interventional endoscopy. The fading boundaries brought with them resistance and even resentment and called for a mutual regulation by the professional associations which took place 10 years ago. Nowadays, surgeons and gastroenterologists in Germany are trained in interventional endoscopy and are the foundation of endoscopic interdisciplinary teamwork in emergency care, diagnostics, therapy, complication management and palliative treatment. Technical innovations striving for a minimization of operative trauma like NOTES depend on the cooperation of both fields of expertise. The driving force behind these efforts should be the shared interest in further improvement of patient care at the highest level of individual expertise, patient-oriented process optimization and adequate use of resources.

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“…Ein Schwerpunkt der diesjährigen Jahrestagung des DPC lag auf der Translation von Forschungsergebnissen in die Klinik und auf klinischen Studien in der Pankreaschirurgie. Zu diesem Thema hielt Christoph Seiler aus Heidelberg einen hochrelevanten Vortrag, in dem der Stand der vor allem chirurgischen-klinischen Forschung in Deutschland im internationalen Vergleich dargestellt wurde [4][5][6][7]. In diesem Bereich wurde in den letzten Jahren, unter anderem durch die Etablierung des Studienzentrums der Deutschen Gesellschaft für Chirurgie, SDGC, und des Chir-NET, die Infrastruktur für qualitativ hochwertige randomisierte Studien geschaffen.…”

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