title: Transection using bipolar scissors reduces pancreatic fistula after distal pancreatectomy.
abstract: OBJECTIVE
  Various methods and technique for treating the surgical stump of the remnant pancreas have been reported to reduce pancreatic fistula after distal pancreatectomy (DP). However, appropriate surgical stump closure after DP is still controversial. We aimed to clarify whether using bipolar scissors in DP reduces pancreatic fistula compared to hand-sewn suture of surgical stump closure.
  
  
  METHODS
  Between January 1989 and December 2005, handsewn suture of surgical stump closure was performed (n=49), and bipolar scissors was prospectively performed between January 2006 and July 2007 (n=26).
  
  
  RESULTS
  The overall rate of pancreatic fistula after DP was 22 patients (29%). There were significant differences between the hand-sewn suture group (41%) and bipolar scissors group (8%) concerning pancreatic fistula (P=0.0164). A multivariate logistic regression analysis revealed that two factors, soft pancreas and hand-sewn suture compared to bipolar scissors, were independent risk factors of pancreatic fistula after DP (P=0.011 and 0.0361, respectively).
  
  
  CONCLUSIONS
  Bipolar scissors for transection of the pancreas is a useful device to reduce pancreatic fistula after DP.
authors.affiliation: Second Department of Surgery, Wakayama Medical University, School of Medicine, 811-1 Kimiidera, Wakayama 641-8510, Japan.
authors.forename: Manabu
authors.initials: M
authors.lastname: Kawai
authors.forename: Masaji
authors.initials: M
authors.lastname: Tani
authors.forename: Hiroki
authors.initials: H
authors.lastname: Yamaue
mesh_terms: D000230:Adenocarcinoma / Q000601:surgery; D000368:Aged; D004867:Equipment Design; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy / Q000009:adverse effects* / Q000295:instrumentation*; D010185:Pancreatic Fistula / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D010190:Pancreatic Neoplasms / Q000601:surgery; D011183:Postoperative Complications / Q000517:prevention & control; D011446:Prospective Studies; D012307:Risk Factors; D013536:Suture Techniques / Q000295:instrumentation*