Recently, the team of pancreas center of the First Affiliated Hospital of Nanjing Medical University, on behalf of the international pancreatic surgery research group (ISGPS), published the title of "management of the pancreatic transformation plane after left (total) Pancreatology: expert consultants guidelines by the international study group of pancreatic surgery (ISGPS)" on the international authoritative surgical journal, surge The expert consensus provides comprehensive evidence and expert interpretation for the treatment of pancreatic stump after pancreatectomy and the prevention of postoperative pancreatic fistula and other complications.
Pancreatic fistula is an eternal topic in pancreatic surgery. Since the day of pancreatic surgery, pancreatic fistula has always been with us. The incidence of pancreatic fistula after distal pancreatectomy is as high as 20% - 35%. The incidence of clinically related pancreatic fistula can further lead to other complications (including bleeding, infection, etc.), thus prolonging the length of stay and increasing medical costs. Therefore, on the basis of the current clinical evidence, how to deal with the pancreatic stump after pancreatectomy and reduce the incidence of pancreatic fistula need to form a consensus of experts, in order to guide clinical practice.
Nanjing pancreas forum 2018 ISGPS Roundtable
At present, there are different ways to deal with the pancreatic stump after pancreatectomy in the field of pancreatic surgery. In this paper, we have included 16 randomized trials since 2005. The purpose of this study is to evaluate the clinical application evidence of various technical methods for the treatment of pancreatic stump after pancreatectomy and their impact on the occurrence of pancreatic fistula To reach a consensus and guide clinical practice. The issues involved in this paper and their expert statements were finalized by some members of ISGPS after discussion during the Nanjing pancreas forum held in Nanjing in 2018, and were voted by all members of ISGPS in the form of Likert 9 subscale. Among them, the highly agreed expert statements include: there is no difference in the occurrence of pancreatic fistula after pancreatectomy with manual suture or closure device; the closure device is not suitable for the closure of all pancreatic stumps; the use of energy devices or chemical tissue sealers, or both, does not affect the occurrence of postoperative pancreatic fistula; open, endoscopic or robotic pancreatectomy Except that there is no difference in the incidence of postoperative pancreatic fistula; there are clinically significant and patient-related risk factors of postoperative pancreatic fistula, these expert statements have important clinical guidance significance. In addition, the expert statement on the preventive use of somatostatin analogues, placement of pancreatic stent, closure and anastomosis of pancreatic stump, and application of abdominal drainage failed to form an effective consensus, which pointed out the future direction for clinical research of pancreatic surgery.
As the founder of international standard definitions such as pancreatic fistula, bleeding and gastric emptying disorder after pancreatectomy, ISGPS is an academic organization leading and standardizing the development of pancreatic surgery in the world. It is composed of famous experts and professors in the field of pancreatic surgery from the top pancreatic centers in various regions in the world. Its published guidelines were once regarded as the "Bible" of pancreatic surgery by domestic scholars. In 2017, Professor Miao Yi, as a co-author on behalf of Chinese scholars, first participated in the publication of ISGPS expert consensus on Pancreaticoenterostomy after pancreatoduodenectomy. The latest ISGPS expert consensus on the treatment of pancreaticoidectomy stump is the first consensus guide of ISGPS issued by Chinese scholars, which is of great significance to the pancreas center of the First Affiliated Hospital of Nanjing Medical University It has a "milestone" significance, which marks a more in-depth exchange between domestic pancreatic surgery field and international counterparts, reflects the continuous and effective practical cooperation between the pancreatic center of the First Affiliated Hospital of Nanjing Medical University, and significantly improves the international influence and academic status of our pancreatic specialty.
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Chinese Journal of pancreatic diseases