• Sefa Ozyazici and Osman Erdogan.
• Department of General Surgery, Adana City Training and Research Hospital, Adana, Turkey.
• J Coll Physicians Surg Pak. 2021 Oct 1; 31 (10): 1214-1218.

ObjectiveTo analyse clinicopathological variables to determine risk factors of postoperative pancreatic fistula in patients having distal pancreatectomy with stapler closure.Study DesignObservational study.Place And Duration Of StudyAdana City Training and Research Hospital, Adana, Turkey, from January 2015 to May 2020.MethodologyMedical files of 38 cases having distal pancreatectomy with stapler closure of the pancreatic remnant for conditions emerging from the pancreas or other organs were analysed. Data about demographics, perioperative and pathological findings, postoperative outcomes were gathered. Univariate analysis was utilised for comparisons of categorical data. The possible risk factors found to be significant in the univariate analysis were included into the logistic regression analysis.ResultsBased on the description reported by the International Study Group of Pancreatic Surgery, 23.7% and 31.6% of the patients had biochemical leakage and clinically relevant postoperative pancreatic fistula (POPF) respectively. Univariate and multivariate analyses made to determine risk factors of POPF showed a relation between stapler closure alone (p = 0.018) and soft parenchymal texture (p = 0.002) and clinically relevant POPF. Multivariate analyses revealed that parenchymal texture was the sole independent predictor of clinically relevant POPF (OR, 0.016, p = 0.039).ConclusionSoft pancreatic texture is independently predictive of clinically relevant POPF following distal pancreatectomy with stapler closure. However, reinforcement of the stapler line with extra sutures decreases the risk of clinically relevant POPF. Key Words: Distal pancreatectomy, Pancreatic fistula, Stapler closure, Suture reinforcement.

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