Distal pankreatektomide pankreas güdüğünü kapatma yöntemlerinin postoperatif pankreatik fistül üzerine etkisi

Göksever Akpınar; Batuhan Eyduran; Korhan Tuncer; Fatma Dikişer; Necdet Güler

doi:10.19161/etd.1429805

EN TR

EFFECT OF PANCREAS STUMP CLOSING METHODS IN DISTAL PANCREATECTOMY ON POSTOPERATIVE PANCREATIC FISTULA

Abstract

Aim: Our study aimed to investigate the relationship between the pancreatic stump closure methods and POPF in DP. Materials and Methods: Patients who underwent DP in our hospital between 2017 and 2023 were retrospectively scanned. The patients were divided into two groups, the group that developed POPF and the group that did not develop, according to the ISGPF 2016 definition. The stump closure methods used in the operation are; They were examined in 3 groups: suturing, stapler use, and stapler use followed by suturing. By comparing the groups with and without POPF as a result of each method applied, the relationship of each method with POPF was evaluated statistically. Results: In the study, 27 patients were enrolled. Among the patients who underwent DP, 10 had a pancreatic tumor, 11 had a tumor of another organ that invaded the pancreas, 5 had a trauma, and 1 had a hydatid cyst. 16 (59.3%) of the patients were male and 11 (40.7%) were female. The median age was 63 (44-70). While the number of patients without POPF was 20 (74%), the number of patients with POPF was 7 (26%). In the group without POPF, the number of patients whose method of closing the pancreatic stump was suture was 11 (55%), 8 (40%) had the use of stapler, and 1 (5%) had the use of stapler followed by suture. In the group with POPF, the number of patients whose method of closing the pancreatic stump was suture was 3 (42.8%), 2 (28.6%) had the use of stapler, and 2 (28.6%) had suture following the use of stapler. There was no statistically significant difference between the groups (p:0.232). Conclusion: No significant relationship was found between the pancreatic stump closure methods and POPF in our study. However, there are also different studies in the literature showing that the methods are superior to each other. Further studies on the subject in the future will be quite beneficial in shedding light on the issue.

Keywords

Distal pankreatektomide pankreas güdüğünü kapatma yöntemlerinin postoperatif pankreatik fistül üzerine etkisi

Öz

Amaç: Çalışmamızda, DP’de pankreas güdüğünü kapatma yöntemleri ile POPF arasındaki ilişkinin araştırılması amaçlanmıştır. Gereç ve Yöntem: Hastanemizde 2017-2023 yıllarında DP uygulanan hastalar, retrospektif olarak tarandı. Hastalar, ISGPF 2016 tanımlamasına göre POPF gelişen grup ve gelişmeyen grup olmak üzere iki gruba ayrıldı. Güdük kapatma yöntemleri; sütürasyon, stapler kullanımı, stapler kullanımını takiben sütürasyon olmak üzere 3 grupta incelendi. Uygulanan her yöntemin sonucunda POPF görülen ve görülmeyen gruplar karşılaştırılarak yöntemlerin her birinin POPF ile ilişkisi istatistiksel açıdan değerlendirildi. Bulgular: Çalışmaya 27 hasta dahil edildi. Hastalardan 10’una (%37,1) pankreas tümörü, 11’ine (%40,7) pankreasa invazyon gösteren başka organ tümörü, 5’ine (%18,5) travma, 1’ine (%3,7) kist hidatik nedeniyle DP uygulanmıştı. Hastaların 16’sı (%59,3) erkek, 11’i (%40,7) kadındı. Ortanca yaş 63 (44-70) idi. POPF görülmeyen hasta sayısı 20 (%74) iken POPF görülen hasta sayısı 7 (%26) idi. POPF görülmeyen grupta pankreas güdüğünü kapatma yöntemi sütürasyon olan hasta sayısı 11 (%55), stapler kullanımı olan 8 (%40), stapler kullanımını takiben sütürasyon olan 1 (%5) idi. POPF görülen grupta pankreas güdüğünü kapatma yöntemi sütürasyon olan hasta sayısı 3 (%42,8), stapler kullanımı olan 2 (%28,6), stapler kullanımını takiben sütürasyon olan hasta sayısı 2 (%28,6) idi. Gruplar arasında istatistiksel olarak anlamlı fark saptanmadı (p:0,232). Sonuç: Çalışmamızda pankreas güdünü kapatma yöntemleri ile POPF arasında anlamlı ilişki saptanmadı. Ancak yöntemlerin birbirinden üstün olduğunu gösteren farklı çalışmalar da literatürde mevcuttur. İlerleyen dönemde konuyla ilgili daha fazla çalışma yapılması konunun aydınlatılmasında oldukça faydalı olacaktır.

Anahtar Kelimeler

Kaynakça

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Ayrıntılar

Birincil Dil

Türkçe

Konular

Genel Cerrahi

Bölüm

Araştırma Makalesi

Yazarlar

Göksever Akpınar
0000-0002-0648-7767
Türkiye

Batuhan Eyduran ^*
0000-0003-0751-2538
Türkiye

Korhan Tuncer
0000-0001-7458-828X
Türkiye

Fatma Dikişer
0000-0001-6256-0124
Türkiye

Necdet Güler
0000-0002-5956-7461
Türkiye

Yayımlanma Tarihi

9 Eylül 2024

Gönderilme Tarihi

5 Şubat 2024

Kabul Tarihi

30 Nisan 2024

Yayımlandığı Sayı

Yıl 2024 Cilt: 63 Sayı: 3

DOI

https://doi.org/10.19161/etd.1429805

IZ

https://izlik.org/JA48AM38ZH

Kaynak Göster

RIS / Bibtex

Vancouver

1.Göksever Akpınar, Batuhan Eyduran, Korhan Tuncer, Fatma Dikişer, Necdet Güler. Distal pankreatektomide pankreas güdüğünü kapatma yöntemlerinin postoperatif pankreatik fistül üzerine etkisi. ETD. 01 Eylül 2024;63(3):422-7. doi:10.19161/etd.1429805