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Comparison of ultrasonically activated scalpel versus conventional division for the pancreas in distal pancreatectomy
Author(s) -
Sugo Hiroyuki,
Mikami Youshi,
Matsumoto Fumio,
Tsumura Hidenori,
Watanabe Yozo,
Futagawa Shunji
Publication year - 2001
Publication title -
journal of hepato‐biliary‐pancreatic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 0944-1166
DOI - 10.1007/s005340170007
Subject(s) - medicine , pancreatic fistula , pancreas , pancreatectomy , surgery , distal pancreatectomy , incidence (geometry) , physics , optics
Purpose: The goal of this study was to compare the benefits and complications of using an ultrasonically activated scalpel and conventional division of the pancreas in patients undergoing a distal pancreatectomy. Methods: A retrospective review was performed of all patients who underwent distal pancreatectomy at the Department of Surgery, Koshigaya Municipal Hospital. In the ultrasonically activated scalpel (US) group ( n = 11), the pancreas was divided using coagulation shears. The stump of the pancreas was left open without parenchymal suturing. In the conventional surgical division (CV) group ( n = 20), the pancreas was cut with a knife and the stump was oversewn with interrupted mattress sutures. The main pancreatic duct was ligated in all patients in both groups. The postoperative courses in the two groups were then compared in terms of postoperative serum amylase levels and the incidence of pancreatic fistulas. Results: The postoperative serum amylase levels were significantly lower in the US group than in the CV group ( P < 0.01 on the day of operation). The incidence of pancreatic fistulas was also significantly lower in the US group (0%) than in the CV group (30%) ( P = 0.04). Conclusions: The use of the ultrasonically activated scalpel was found to reduce the incidence of pancreatic fistula in distal pancreatectomy. Furthermore, the use of this device without any clamping or parenchymal suturing may reduce the damage to the remnant pancreas.