Fifteen years’ experience of Distal Pancreatectomy in a Tertiary Center: Trends, Outcomes and Challenges
Eldesoky, M., Magdy Abd Elrazek, H., Gohar, A., Ahmed, M., Abdulrazek, M., Said, R. (2025). Fifteen years’ experience of Distal Pancreatectomy in a Tertiary Center: Trends, Outcomes and Challenges. EKB Journal Management System, 3(3), 62-70. doi: 10.21608/ijhegy.2025.375654.1057
Mohammed Eldesoky; Hassan Magdy Abd Elrazek; Ahmed k. Gohar; Mohamed Sherif Ali Ahmed; Mohamed Abdulrazek; Rami Said. "Fifteen years’ experience of Distal Pancreatectomy in a Tertiary Center: Trends, Outcomes and Challenges". EKB Journal Management System, 3, 3, 2025, 62-70. doi: 10.21608/ijhegy.2025.375654.1057
Eldesoky, M., Magdy Abd Elrazek, H., Gohar, A., Ahmed, M., Abdulrazek, M., Said, R. (2025). 'Fifteen years’ experience of Distal Pancreatectomy in a Tertiary Center: Trends, Outcomes and Challenges', EKB Journal Management System, 3(3), pp. 62-70. doi: 10.21608/ijhegy.2025.375654.1057
Eldesoky, M., Magdy Abd Elrazek, H., Gohar, A., Ahmed, M., Abdulrazek, M., Said, R. Fifteen years’ experience of Distal Pancreatectomy in a Tertiary Center: Trends, Outcomes and Challenges. EKB Journal Management System, 2025; 3(3): 62-70. doi: 10.21608/ijhegy.2025.375654.1057

Fifteen years’ experience of Distal Pancreatectomy in a Tertiary Center: Trends, Outcomes and Challenges

International Journal of Health Sciences (Egypt)
Volume 3, Issue 3, July 2025, Page 62-70  XML PDF (713.09 K)
Document Type: Original Article
DOI: 10.21608/ijhegy.2025.375654.1057
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Authors
Mohammed Eldesoky email 1; Hassan Magdy Abd Elrazek2; Ahmed k. Gohar3; Mohamed Sherif Ali Ahmed4; Mohamed Abdulrazek1; Rami Said1
1Gastrointestinal surgery center, Mansoura Faculty of Medicine, Mansoura University, Egypt
2Radiology Specialist Radiology Department, Gastrointestinal Surgery Center, Mansoura University, Egypt
3Faculty of Medicine, Delta University for Science and Technology, Gamasa, Egypt
4Faculty of Medicine, Mansoura University, Egypt
Abstract
Background:  Distal pancreatectomy (DP) is a standard surgical approach for managing various benign and malignant pancreatic lesions. Despite advancements, postoperative pancreatic fistula (POPF) remains a significant complication, and there is ongoing debate surrounding optimal surgical techniques and stump closure methods. Methods: This retrospective study reviewed 110 patients who underwent DP at Mansoura University between 2010 and 2024. Data included demographics, clinical presentation, operative details, and postoperative outcomes. The primary focus was identifying risk factors for POPF using statistical comparisons between patients with and without POPF. Results: POPF occurred in 27.5% of cases, predominantly Grade A. Significant predictors of POPF included reduced pancreatic stump thickness (2.7 ± 1.2 mm vs. 4.2 ± 0.6 mm, p < 0.0001), lower pancreatic thickness-to-duct (P/D) diameter ratio (1.7 ± 0.7 vs. 2.7 ± 1.2, p = 0.001), use of energy-based division (p = 0.01), and failure to close the pancreatic duct (p = 0.03). Results suggested increased POPF risk was noted with anterior duct position and increased blood loss. Omental covering showed a non-significant trend towards reduced POPF. Conclusions: Thinner pancreatic remnants, lower P/D ratios, energy-based division, and duct non-closure are associated with increased POPF risk following DP. Recognizing these risk factors can guide surgical decision-making to improve outcomes.
Keywords
Distal pancreatectomy; postoperative pancreatic fistula; pancreatic stump; surgical technique; complication risk factors
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