Efficacy of pancreatic dissection with a triple-row stapler in laparoscopic distal pancreatectomy: a retrospective observational study

Abstract Background Postoperative pancreatic fistulas (POPFs) occur after 20–30% of laparoscopic distal pancreatectomies and can have serious consequences. This study aimed to evaluate the clinical efficacy of laparoscopic distal pancreatectomy using a triple-row stapler for preventing POPF. Methods Between April 2016 and May 2023, 59 patients underwent complete laparoscopic distal pancreatectomies. There were more females (n = 34, 57.6%) than males (n = 25, 42.4%). The median age of the patients was 68.9 years. The patients were divided into slow-compression and no-compression groups and examined for pancreatic leakage. Both groups were examined with respect to age, sex, body mass index (BMI), pancreatic thickness at the pancreatic dissection site, pancreatic texture, diagnosis, operative time, blood loss, presence of POPF, date of drain removal, and length of hospital stay. In addition, risk factors for POPF were examined in a multivariate analysis. Results Grade B POPFs were found in 9 patients (15.3%). The slow-compression and no-compression groups included 19 and 40 patients, respectively. Univariate analysis showed that the operative time, blood loss, postoperative pancreatic fluid leakage, day of drain removal, and hospital stay were lower in the no-compression group than in the slow-compression group. The no-compression group was older than the slow-compression group. In the multivariate analysis, the absence of POPF was significantly more frequent in the no-compression group (odds ratio,5.69; 95% confidence interval, 1.241–26.109; p = 0.025). Conclusions The no-compression pancreatic dissection method is a simple method for reducing POPF incidence.