title: Use of ultrasonically activated shears improves the safety of pancreaticojejunostomy after pancreaticoduodenectomy.
abstract: OBJECTIVE
  To study whether the use of ultrasonically activated shears (UAS) would improve the safety of pancreatojejunal anastomosis after pancreaticoduodenectomy.
  
  
  METHODS
  Retrospective analysis.
  
  
  METHODS
  University teaching hospital.
  
  
  METHODS
  Seventy patients underwent pancreaticoduodenectomy between April 1997 and May 2001.
  
  
  METHODS
  Leakage of pancreatojejunal anastomosis as judged from the contents of the drain within 7 days after operation, and defined as a high amylase level of discharge that was 3 times higher than that of serum.
  
  
  RESULTS
  Leakage of pancreatojejunal anastomosis was observed in 1 (1.4%) of the 70 cases. Other complications were stomal ulcer, bile leakage, renal failure, and intra-abdominal abscess in one case each.
  
  
  CONCLUSIONS
  Use of UAS to perform pancreatectomy eliminates bleeding and pancreatic juice leakage from the branches of the pancreatic duct. Therefore, the cut surface of the pancreas is kept dry, simplifying anastomosis. Use of UAS improves the safety of pancreatojejunal anastomosis after pancreaticoduodenectomy.
authors.affiliation: Department of Surgery, Hiroshima Prefectural Hospital, 1-5-54 Ujinakanda, Minamiku, Japan. juntan@ipc.hiroshima-u.ac.jp
authors.forename: Tsuneo
authors.initials: T
authors.lastname: Tanaka
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Matsugu
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Fukuda
mesh_terms: D000328:Adult; D000368:Aged; D000681:Amylases / Q000032:analysis / Q000097:blood; D000714:Anastomosis, Surgical / Q000295:instrumentation; D004066:Digestive System Diseases / Q000601:surgery; D004322:Drainage; D005260:Female; D006801:Humans; D007583:Jejunum / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000098:blood supply / Q000601:surgery*; D010189:Pancreatic Juice; D016577:Pancreaticoduodenectomy / Q000009:adverse effects / Q000295:instrumentation*; D010193:Pancreaticojejunostomy / Q000295:instrumentation* / Q000379:methods; D011183:Postoperative Complications; D012189:Retrospective Studies; D013525:Surgical Instruments; D016896:Treatment Outcome; D014463:Ultrasonography
chemical_list: D000681:Amylases