Supplementary Material for: Hanging Maneuver for Stomach Traction in Laparoscopic Distal Pancreatic Resections: An Original Technique Applied in 218 Patients

<strong><em>Background:</em></strong> Stomach traction done to expose the pancreas is still a problem in laparoscopic left pancreatic resections. We developed a simple hanging maneuver to retract the stomach rapidly and effectively. <b><i>Methods:</i></b> After dividing the gastrocolic ligament, the stomach was encircled with a tape, turned along its horizontal axis and pulled with an epigastric trocar, which was later removed. This technique was used in all patients who underwent laparoscopic left pancreatic resections including 165 distal pancreatectomies (DP), 35 central pancreatectomies (CP) and 18 enucleations (En). Demographics, surgical and postoperative outcome data were recorded. <b><i>Results:</i></b> There were no mortalities. The mean operative time for DP, CP and En were 174, 191 and 104 min, respectively. The transfusion (0-4%) and conversion (0-3%) rates were low for all procedures. Morbidity was mainly represented by pancreatic fistula and grades (B + C) for DP, CP and En were observed in 26, 22 and 17%, respectively. No complication related to hanging of the stomach, like gastric perforation, was observed. Re-intervention and the mean hospital stay for DP, CP and En were observed in 5, 11 and 0% and were 16, 22 and 12, respectively. The readmission rate was low (0-9%). <b><i>Conclusions:</i></b> Hanging maneuver of the stomach is a simple procedure to rapidly, safely and effectively retract the stomach during left laparoscopic pancreatic resections.

<strong><em>背景：</em></strong> 在腹腔镜左胰切除术（laparoscopic left pancreatic resection）中，为暴露胰腺而实施的胃牵拉操作仍是一项临床难题。本研究团队研发了一种简易胃悬吊操作法，可快速且有效地牵拉胃部。<b><i>方法：</i></b> 分离胃结肠韧带后，以悬吊带环绕胃部，沿其水平轴翻转，再通过上腹套管针（epigastric trocar）进行牵拉，随后拔除该套管针。本技术应用于所有接受腹腔镜左胰切除术的患者，其中包含165例远端胰腺切除术（distal pancreatectomy, DP）、35例中央胰腺切除术（central pancreatectomy, CP）及18例胰腺剜除术（enucleation, En）。研究人员记录了患者的人口统计学特征、手术相关指标及术后转归数据。<b><i>结果：</i></b> 本研究无患者死亡。远端胰腺切除术、中央胰腺切除术及胰腺剜除术的平均手术时间分别为174、191及104分钟。所有术式的输血率（0~4%）与中转手术率（0~3%）均处于较低水平。术后并发症以胰瘘为主，远端胰腺切除术、中央胰腺切除术及胰腺剜除术的B级+C级胰瘘发生率分别为26%、22%及17%。未观察到与胃悬吊操作相关的并发症（如胃穿孔）。远端胰腺切除术、中央胰腺切除术及胰腺剜除术的再次干预率分别为5%、11%及0%，平均住院时间分别为16、22及12天。再入院率较低（0~9%）。<b><i>结论：</i></b> 胃悬吊操作法是一种在腹腔镜左胰切除术中，可快速、安全且有效牵拉胃部的简易手术操作。