Proximal pancreatectomy: a comparison of electrocautery and contact and noncontact Nd:YAG laser techniques in the dog.
Proximal pancreatectomy with duodenal preservation is technically difficult. It has often been performed experimentally in pancreatic transplantation studies. Preservation of the pancreaticoduodenal vessels and duodenum provides an excellent method of testing various operative techniques in pancreatic surgery which may lead to further clinical applications. The present study has compared the conventional noncontact Nd:YAG laser technique with electrocautery and a new contact Nd:YAG laser technique for proximal pancreatectomy. There were five dogs in each group, and the pancreatic duct was left open to drain into the abdominal cavity after pancreatic transection in all of the animals. Resection with the contact laser caused significantly less blood loss (109 +/- 74 ml) than the noncontact laser (228 +/- 81 ml), (p less than 0.05). A greater number of ligatures were used in the noncontact laser group (11 +/- 3 ligatures) as compared with the electrocautery group (2.2 +/- 1.6 ligatures) and the contact laser group (5.2 +/- 2.8 ligatures), (p less than 0.005). Noncontact laser and electrocautery resection techniques resulted in necrotizing pancreatitis and death in two animals. The new contact laser system provides a safe and effective method of performing pancreatic surgery.
Schröder
T
T
Department of Surgery, University of Cincinnati Medical Center, Ohio 45267.
Brackett
K
K
Joffe
S N
SN
D000818:Animals; D004285:Dogs; D004564:Electrocoagulation; D053685:Laser Therapy; D010179:Pancreas / Q000473:pathology; D010180:Pancreatectomy / Q000379:methods*