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Erschienen in: European Surgery 6/2022

06.10.2022 | original article

Perioperative management of pancreatic excretory function in the context of pancreatic head resections in PDAC patients

Is the choice of secretion inhibition showing an effect on the rate of clinically relevant fistulas (CR-POPF)?

verfasst von: MD MBA FEBS Siegfried Sauseng, Arvin Imamovic, Josip Kresic, Thomas Niernberger, Hans Rabl

Erschienen in: European Surgery | Ausgabe 6/2022

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Summary

Introduction

Postoperative pancreatic fistulas (POPF) are possible origins of dangerous and life-threatening complications after pancreatic head resections. In 2020, a review with over 52,000 patients showed that patients without secretion inhibition (SI) show a higher tendency to develop a POPF. However, there is still no consensus regarding the use of secretion inhibition or in which way it should be administered. The aim of our study is to show whether SI with somatostatin is superior to inhibition with a somatostatin analogue (SA).

Methods

This retrospective data analysis was retrieved from an existing databank. Between 3/2015 and 12/2018, a total of 66 PDAC patients underwent pancreatic head resection. In this group, somatostatin was used as a perioperative secretion inhibitor. The comparison group (n = 91) operated from 1/2010 to 12/2014 received an SA for inhibition. These groups were compared regarding the occurrence of clinically relevant (CR)-POPF.

Results

The frequency rates for biochemical leakage, type B, and type C fistulas in the SA group were 17.58% (n = 16), 30.76% (n = 28), and 9.89% (n = 9), respectively. The somatostatin group showed the following frequencies: 24.2% (n = 16) for biochemical leakage, 16.7% (n = 11) for type B, and 6.1% (n = 4) for type C fistulas. The overall occurrence of CR-POPF was significantly reduced in the somatostatin group (p = 0.0069).

Conclusion

The perioperative use of somatostatin is superior to the use of a somatostatin analogue for POPF prevention in the context of oncological pancreatic head resections.
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Metadaten
Titel
Perioperative management of pancreatic excretory function in the context of pancreatic head resections in PDAC patients
Is the choice of secretion inhibition showing an effect on the rate of clinically relevant fistulas (CR-POPF)?
verfasst von
MD MBA FEBS Siegfried Sauseng
Arvin Imamovic
Josip Kresic
Thomas Niernberger
Hans Rabl
Publikationsdatum
06.10.2022
Verlag
Springer Vienna
Erschienen in
European Surgery / Ausgabe 6/2022
Print ISSN: 1682-8631
Elektronische ISSN: 1682-4016
DOI
https://doi.org/10.1007/s10353-022-00779-3

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