Site of pancreatic resection and pancreatic fistula in distal pancreatectomy: What are we leaving behind?
Javier A Cienfuegos 1 , Luis Hurtado-Pardo 2 , Alberto Benito 3 , Fernando Rotellar 4
Hirono et al.  make an in-depth analysis of the relationship between the site of transection of the pancreas in distal pancreatectomy (neck vs body) and the development of postoperative pancreatic fistulas (POPF) and long-term endocrine function.
In their study they report an incidence of pancreatic fistula (grade B/C) which was significantly higher (p = 0.042) when the transection of the pancreas was performed in the body (21.4%) rather than in the neck of the pancreas (6.5%). It is worth highlighting that no sparing of the splenic vessels was performed.
The authors establish a link between these findings and the different width of the pancreatic parenchyma at the site of the transection, which is greater in the body than in the neck of the pancreas (17.5 mm vs 11.9 mm; p < 0.001) and which would lead to the stapling of the pancreatic tissue at this site to be defective .
CITATION Pancreatology. 2021 Jun;21(4):835-836.
doi: 10.1016/j.pan.2021.03.010. Epub 2021 Mar 19.