Pancreatic transection using a sharp hook-shaped ultrasonically activated scalpel.
OBJECTIVE
The operative mortality and morbidity associated with pancreatic surgery has been decreasing; however, pancreatic fistula remains a major cause of a potentially fatal complication. Although different devices and techniques have been proposed to reduce of the postoperative pancreatic fistula, none has gained unanimous acceptance. We herein describe a new technique for pancreatic transection using a sharp hook-shaped ultrasonically activated scalpel (UAS).


METHODS
Between December 2004 and June 2006, 32 patients who had undergone pancreatectomies performed using the sharp hook-shaped UAS (Ethicon Endo-Surgery, Cincinnati, OH, USA) were studied.


RESULTS
The incidence of pancreatic fistula in these patients was 6.3% (2/32). Both cases underwent a distal pancreatectomy. No patient had systemic organ failure induced by postoperative pancreatic fistula, and conservative drainage management improved the pancreatic fistula. No pancreatic fistulas developed in patients who underwent pancreaticoduodenectomy with a duct-to-mucosa anastomosis pancreaticojejunostomy after pancreatic transection using the sharp hook-shaped UAS.


CONCLUSIONS
Pancreatic transection using the sharp hook-shaped UAS is an easy and useful method that facilitates detection of the main pancreatic duct with minimal blood loss. It may contribute to lower morbidity and mortality after pancreatic resection.
Okabayashi
Takehrio
T
Department of Surgery, Kochi Medical School, Kohasu-Okocho, Nankoku-City, Kochi, Japan. tokabaya@kochi-u.ac.jp
Hanazaki
Kazuhiro
K
Nishimori
Isao
I
Sugimoto
Takeki
T
Yoshioka
Ryuji
R
Dabanaka
Ken
K
Kobayashi
Michiya
M
Onishi
Saburo
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical / Q000517:prevention & control; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy / Q000295:instrumentation*; D010185:Pancreatic Fistula / Q000517:prevention & control*; D010190:Pancreatic Neoplasms / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000295:instrumentation*; D050500:Pancreatitis, Chronic / Q000601:surgery*; D011183:Postoperative Complications / Q000517:prevention & control*; D013525:Surgical Instruments; D014464:Ultrasonic Therapy / Q000295:instrumentation*; D055815:Young Adult