title: Use of a new sealing device to simplify jejunal resection during pancreaticoduodenectomy.
abstract: BACKGROUND
  Pancreaticoduodenectomy has undergone numerous technical modifications since the original reported series in 1935, but little focus has been directed to the dissection and ligation of the mesenteric blood supply to the first portion of the jejunum.
  
  
  METHODS
  Sixty-four patients in whom the device was used were compared to a historical cohort of 128 patients who had undergone pancreaticoduodenectomy at our institution.
  
  
  RESULTS
  The technique described provided a rapid, ergonomically efficient method to complete step 5 of pancreaticoduodenectomy. We found no differences in average hospital length of stay (LOS), reoperation rate, morbidity, mortality, or postoperative readmission rates between patients operated on before or after adoption of this technique
  
  
  CONCLUSIONS
  The Ligasure sealing device (Valleylab, Boulder, CO) provides an excellent, safe alternative to the classic use of clamps and ties when resecting the first portion of the jejunum during pancreaticoduodenectomy.
authors.affiliation: Pancreas Research Group and the Department of Surgery, Indiana University School of Medicine, Indianapolis, IN 46202, USA. tjhoward@iupui.edu
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Howard
authors.forename: Scott
authors.initials: S
authors.lastname: Mimms
mesh_terms: D004564:Electrocoagulation / Q000295:instrumentation* / Q000379:methods; D006488:Hemostasis, Surgical / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D007583:Jejunum / Q000098:blood supply* / Q000601:surgery; D008638:Mesenteric Arteries / Q000601:surgery; D008642:Mesenteric Veins / Q000601:surgery; D016577:Pancreaticoduodenectomy / Q000295:instrumentation* / Q000379:methods