ArticleSurgical endoscopy2020
Technique and audited outcomes of laparoscopic distal pancreatectomy combining the clockwise approach, progressive stepwise compression technique, and staple line reinforcement.
Article in Surgical endoscopy, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06141044 (PANDREAS. Prophylactic Abdominal Drainage vs no Drainage After Distal Pancreatectomy), which is not on this map. Cited by 14 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
PANDREAS. Prophylactic Abdominal Drainage vs no Drainage After Distal Pancreatectomy: a Multicentre Clinical Trial
Who cites it
14 citing papers in PubMed, 45 citations in OpenAlex.
- A randomized controlled trial of stapled versus ultrasonic transection in distal pancreatectomy.Surgical endoscopy · 2022Trial
- Robotic crush and clip technique for pancreatic transection in robotic distal pancreatectomy.Surgical endoscopy · 2026Article
- Optimizing Robotic Spleen-Preserving Distal Pancreatectomy: Strategies and Innovations to Enhance Safety and Efficacy.Annals of surgical oncology · 2025Article
- Effect of differences in vascular anatomy on surgical outcomes of left pancreatectomy: a retrospective study.World journal of surgical oncology · 2025Article
- Laparoscopic Central Pancreatectomy with Modified Blumgart Pancreatojejunostomy for Pancreatic Neuroendocrine Tumor.Annals of surgical oncology · 2024Article
- Laparoscopic distal pancreatectomy for pancreatic cancer: an overview of evaluation and treatment strategies.Journal of gastrointestinal oncology · 2024Article
- Robotic Pancreatoduodenectomy in Portal Annular Pancreas Using a Hanging Maneuver with Indocyanine Green Fluorescence Imaging.Annals of surgical oncology · 2024Article
- Endoscopic main duct stenting in refractory postoperative pancreatic fistula after distal pancreatectomy - a friend or a foe?BMC surgery · 2024Article
- Preliminary experience with a new robotic technique to facilitate distal pancreatectomy with spleen preservation: left lateral approach in right lateral decubitus position.Journal of robotic surgery · 2023Article
- Preoperative CT image analysis to improve risk stratification for clinically relevant pancreatic fistula after distal pancreatectomy.The British journal of surgery · 2023Article
- Management of clinically relevant postoperative pancreatic fistula-related fluid collections after distal pancreatectomy.Surgical endoscopy · 2023Article
- Counter-Clockwise Approach for Robotic Pylorus-Preserving Pancreatoduodenectomy.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2022Article
- HOW TO PERFORM LAPAROSCOPIC DISTAL PANCREATECTOMY USING THE CLOCKWISE TECHNIQUE.Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery · 2022Article
- The Role of Laparoscopic Surgery in Localized Pancreatic Neuroendocrine Tumours.Current treatment options in oncology · 2021Review
Corrections and comments
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Authors and funding
8 authors at 5 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLaparoscopic distal pancreatectomy (LDP) has proven advantages over its open counterpart and is becoming more frequently performed around the world. It still remains a difficult operation due to the retroperitoneal location of the pancreas and limited experience and training with the procedure. In addition, complications such as bleeding or postoperative pancreatic fistula (POPF) remain a problem. A standardized approach to LDP with stepwise graded compression technique for pancreatic transection has been utilized at a single center, and we sought to describe the technique and determine the outcomes.
methodsA review of all patients undergoing LDP by a clockwise approach including the graded compression technique from August 1, 2008 to December 31, 2017 was performed. An external audit was performed by the Dutch Pancreatic Cancer Group.
resultsOverall, 260 patients with a mean age and a BMI of 62.3 and 28, respectively, underwent LDP using this technique. Mean operative time and blood loss were 183 min and 248 mL, respectively,. Hand-assisted method and conversion to open were both 5%. Major morbidity and mortality were 9.2% and 0.4%, respectively,. POPF was noted in 8.1%. The technical steps include (1) mobilization of the splenic flexure of the colon and exposure of the pancreas, (2) dissection along the inferior edge of the pancreas and choosing the site for pancreatic division, (3) pancreatic parenchymal division using a progressive stepwise compression technique with staple line reinforcement, (4) ligation of the splenic vein and artery, (5) dissection along the superior edge of the pancreas and residual posterior attachments, and (6) mobilization of the spleen and specimen removal.
conclusionLDP with a clockwise approach for dissection, combined with the progressive stepwise compression technique for pancreatic transection, resulted in excellent outcomes including a very low POPF rate.
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