Thomas J Howard1, Scott Mimms. 1. Pancreas Research Group and the Department of Surgery, Indiana University School of Medicine, Indianapolis, IN 46202, USA. tjhoward@iupui.edu
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 CONCLUSION: 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.
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 CONCLUSION: 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: Oliver S Eng; Julie Goswami; Dirk Moore; Chunxia Chen; Jennifer Brumbaugh; Christopher J Gannon; David A August; Darren R Carpizo Journal: HPB (Oxford) Date: 2013-06-19 Impact factor: 3.647