• Masafumi Nakamura, Koji Shindo, Noboru Ideno, Junji Ueda, Shunichi Takahata, Hiroshi Nakashima, Takao Ohtsuka, Shuji Shimizu, Yoshinao Oda, and Masao Tanaka.
• Hepato Gastroenterol. 2014 May 1; 61 (131): 834-7.

Background/AimsThis retrospective study was conducted to find preoperatively assessable risk factors for postoperative pancreatic fistula (POPF) in patients undergoing laparoscopic distal pancreatectomy (LDP) using a slow compression method with a stapler, which we call pen-firing compression (PFC).MethodologyFifty-two patients underwent LDP, of whom 42 underwent PFC for pancreatic division using a stapler. The relationship between preoperatively assessable factors and the incidence of clinical POPF was statistically analyzed.ResultsOverall rate of POPF was 7.1% in 42 patients. Univariate analysis showed that greater BMI (p = 0.004) and thicker pancreatic stump (0.0022) were significant risk factors for POPF. BMI and stump thickness remained significant (P < 0.0001, P < 0.0001) by multivariate analysis. Cutoff points estimated by ROC curve were 27 kg/m2 for BMI and 27 mm for stump thickness.ConclusionsHigh BMI value and thick pancreatic stump are significant risk factors for POPF after LDP. Alternative treatment of the pancreatic stump may prevent POPF in high-risk patients.

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