title: Pancreatic transection using a sharp hook-shaped ultrasonically activated scalpel.
abstract: 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.
authors.affiliation: Department of Surgery, Kochi Medical School, Kohasu-Okocho, Nankoku-City, Kochi, Japan. tokabaya@kochi-u.ac.jp
authors.forename: Takehrio
authors.initials: T
authors.lastname: Okabayashi
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Hanazaki
authors.forename: Isao
authors.initials: I
authors.lastname: Nishimori
authors.forename: Takeki
authors.initials: T
authors.lastname: Sugimoto
authors.forename: Ryuji
authors.initials: R
authors.lastname: Yoshioka
authors.forename: Ken
authors.initials: K
authors.lastname: Dabanaka
authors.forename: Michiya
authors.initials: M
authors.lastname: Kobayashi
authors.forename: Saburo
authors.initials: S
authors.lastname: Onishi
mesh_terms: 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