Efficacy of Linear Stapler With Polyglycolic Acid Felt for Preventing Graft Duodenal Perforation After Pancreas Transplant

Objectives: Graft duodenal perforation is a serious complication in pancreas transplantation. The aim of this study was to evaluate whether using a reinforced linear stapler during bench surgery in pancreas transplant affects the risk of graft duodenal perforation. Materials and Methods: This retrospective study included 47 patients who underwent pancreas transplant at our institution from 2011 to 2020. A reinforced stapler with polyglycolic acid felt was used to dissect the graft duodenum during bench surgery in 16 of the 47 patients (reinforced group). A conventional linear stapler was used in the remaining 31 patients (conventional group). Demographic, perioperative, and postoperative parameters were compared between the reinforced group and the conventional group. Results: Graft duodenal perforation occurred in 6 patients (19.4%) in the conventional group and in none of the patients in the reinforced group. Logistic regression analysis revealed no significant as-sociations between donor-or recipient-related factors and graft duodenal perforation. Among operative factors, use of a reinforced stapler was the only factor significantly associated with the risk of graft duodenal perforation (odds ratio = 0.12). Conclusions: The use of a reinforced stapler during dissection of the duodenum in bench surgery for pancreas transplant was associated with a lower riskof graft duodenal perforation than use of a conventional stapler.