title: Safety and efficacy of LigaSure usage in pancreaticoduodenectomy.
abstract: BACKGROUND
  Over recent years, use of the LigaSure™ vessel sealing device has increased in major abdominal surgery to include pancreaticoduodenectomy (PD). LigaSure™ use during PD has expanded to include all steps of the procedure, including the division of the uncinate margin. This introduces the potential for thermal major vascular injury or margin positivity. The aim of the present study was to evaluate the safety and efficacy of LigaSure™ usage in PD in comparison to established dissection techniques.
  
  
  METHODS
  One hundred and forty-eight patients who underwent PD from 2007 to 2012 at Robert Wood Johnson University Hospital were identified from a retrospective database. Two groups were recognized: those in which the LigaSure™ device was used (N = 114), and in those it was not (N = 34). Peri-operative outcomes were compared.
  
  
  RESULTS
  Vascular intra-operative complications directly caused by thermal injury from LigaSure™ use occurred in 1.8% of patients. Overall vascular intra-operative complications, uncinate margin positivity, blood loss, length of stay, and complication severity were not significantly different between groups. The mean operative time was 77 min less (P < 0.010) in the LigaSure™ group. Savings per case where the LigaSure™ was used amounted to $1776.73.
  
  
  CONCLUSIONS
  LigaSure™ usage during PD is safe and effective. It is associated with decreased operative times, which may decrease operative costs in PD.
authors.affiliation: Department of Surgery, The Cancer Institute of New Jersey, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, NJ.
authors.forename: Oliver S
authors.initials: OS
authors.lastname: Eng
authors.forename: Julie
authors.initials: J
authors.lastname: Goswami
authors.forename: Dirk
authors.initials: D
authors.lastname: Moore
authors.forename: Chunxia
authors.initials: C
authors.lastname: Chen
authors.forename: Jennifer
authors.initials: J
authors.lastname: Brumbaugh
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Gannon
authors.forename: David A
authors.initials: DA
authors.lastname: August
authors.forename: Darren R
authors.initials: DR
authors.lastname: Carpizo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical / Q000517:prevention & control; D017046:Cost Savings; D003362:Cost-Benefit Analysis; D004867:Equipment Design; D005260:Female; D006489:Hemostatic Techniques / Q000009:adverse effects / Q000191:economics / Q000295:instrumentation*; D017721:Hospital Costs; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D018365:Neoplasm, Residual; D010190:Pancreatic Neoplasms / Q000191:economics / Q000473:pathology / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000009:adverse effects / Q000191:economics / Q000295:instrumentation*; D012189:Retrospective Studies; D013525:Surgical Instruments / Q000191:economics; D013997:Time Factors; D016896:Treatment Outcome; D057772:Vascular System Injuries / Q000209:etiology / Q000517:prevention & control; D055815:Young Adult