{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T15:25:15Z","timestamp":1763479515943,"version":"3.30.2"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2003,1,28]],"date-time":"2003-01-28T00:00:00Z","timestamp":1043712000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2003,1,28]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Although much is known about the long-term outcome of patients undergoing left (distal) pancreatectomy for malignancy, comparatively little is known about the optimal management strategy for the residual transected pancreatic parenchyma and the divided pancreatic duct. Clinicopathological and operative factors that may contribute to postoperative pancreatic leak were evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective review of the medical records of 126 patients who underwent left pancreatectomy between June 1990 and December 1999 at the University of Texas M. D. Anderson Cancer Center was performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Indications for left pancreatectomy included pancreatic neoplasms (n = 42; 33\u00b73 per cent), en bloc resection for management of retroperitoneal sarcoma (n = 21; 16\u00b77 per cent), gastric adenocarcinoma (n = 14; 11\u00b71 per cent), renal cell carcinoma (n = 11; 8\u00b77 per cent) and other tumours or benign conditions (n = 38; 30\u00b72 per cent). Pancreatic parenchymal closure was accomplished by a hand-sewn technique, mechanical stapling, or a combination of the two in 83, 20 and 15 patients respectively. No form of parenchymal closure was used in eight patients. Identification of the pancreatic duct and suture ligation was performed in 73 patients (57\u00b79 per cent). Twenty-five patients (19\u00b78 per cent) developed a pancreatic leak. For subgroups having duct ligation or no duct ligation, pancreatic leak rates were 9\u00b76 per cent (seven of 73 patients) and 34\u00b70 per cent (18 of 53 patients) respectively (P &amp;lt; 0\u00b7001). Multivariate analysis including clinicopathological and operative factors indicated that failure to ligate the pancreatic duct was the only feature associated with an increased risk for pancreatic leak (odds ratio 5\u00b70 (95 per cent confidence interval 2\u00b70 to 10\u00b70); P = 0\u00b7001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Pancreatic leak remains a common complication after left pancreatectomy. The incidence of leak is reduced significantly when the pancreatic duct is identified and directly ligated during left pancreatectomy.<\/jats:p><\/jats:sec>","DOI":"10.1002\/bjs.4032","type":"journal-article","created":{"date-parts":[[2003,1,29]],"date-time":"2003-01-29T15:33:23Z","timestamp":1043854403000},"page":"190-196","source":"Crossref","is-referenced-by-count":188,"title":["Pancreatic leak after left pancreatectomy is reduced following main pancreatic duct ligation"],"prefix":"10.1093","volume":"90","author":[{"given":"M M","family":"Bilimoria","sequence":"first","affiliation":[{"name":"Department of Surgical Oncology, Box 444, University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, Texas 77030-4009, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J N","family":"Cormier","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, Box 444, University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, Texas 77030-4009, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Y","family":"Mun","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, Box 444, University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, Texas 77030-4009, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J E","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, Box 444, University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, Texas 77030-4009, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D B","family":"Evans","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, Box 444, University of Texas M. D. 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