• Yuta Yoshida, Ippei Matsumoto, Masataka Matsumoto, Kohei Kawaguchi, Takaaki Murase, Keiko Kamei, Shumpei Satoi, Atsushi Takebe, Takuya Nakai, and Yoshifumi Takeyama.
• Department of Surgery, Faculty of Medicine, Kindai University, 377-2 Ohno-higashi, Osakasayama, Osaka, 589-8511, Japan.
• J Hepatobiliary Pancreat Sci. 2019 Nov 1; 26 (11): 510-516.

BackgroundPostoperative pancreatic fistula (POPF) after distal pancreatectomy (DP) remains the most common surgical complication. We have developed a novel stump closure technique after DP using transpancreatic mattress suture with Vicryl mesh (TMV) and reported our initial findings. The purpose of this study is to evaluate the efficacy of TMV compared to the conventional handsewn stump closure technique (CHS).MethodsThis retrospective single-center study included 165 consecutive patients who underwent open DP from January 2010 to May 2018. Of these, 71 patients underwent DP using TMV after September 2014 and 94 patients underwent DP with CHS. The surgical outcomes were compared between the two groups.ResultsClinically relevant POPF rate in the TMV group was significantly lower than that in the CHS group (5.6% vs. 17.2%, P = 0.027). Morbidity rate was higher in the CHS group than that in the TMV group (16.9% vs. 27.7%, P = 0.104). In the multivariate analysis, absence of additional organ resection (OR 3.57; 95% CI 1.18-10.43; P = 0.025) and TMV (OR 0.24; 95% CI 0.07-0.73; P = 0.010) were identified as independent preventing factors for clinically relevant POPF.ConclusionTMV can be an effective stump closure technique for preventing POPF after DP.© 2019 Japanese Society of Hepato-Biliary-Pancreatic Surgery.

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