Fernando Burdío1, Dimitri Dorcaratto2, Lourdes Hernandez1, Anna Andaluz3, Xavier Moll3, Rita Quesada4, Ignasi Poves1, Luis Grande1, Marta Cáceres5, Enrique Berjano6. 1. a Department of Surgery , Hospital del Mar , Barcelona , Spain . 2. b Department of Surgery , St Vincent's University Hospital , Dublin , Ireland . 3. c Departament de Medicina i Cirurgia Animals , Facultat de Veterinària, Universitat Autònoma de Barcelona , Bellaterra , Spain . 4. d Fundación Instituto Mar de Investigaciones Médicas , Barcelona , Spain . 5. e Hospital Sagrat Cor , Barcelona , Spain , and. 6. f Biomedical Synergy, Electronic Engineering Department, Universitat Politècnica de València , Valencia , Spain.
Abstract
PURPOSE: The aim of this study was to assess the capacity of two methods of surgical pancreatic stump closure in terms of reducing the risk of pancreatic fistula formation (POPF): radiofrequency-induced heating versus mechanical stapler. MATERIALS AND METHODS: Sixteen pigs underwent a laparoscopic transection of the neck of the pancreas. Pancreatic anastomosis was always avoided in order to work with an experimental model prone to POPF. Pancreatic stump closure was conducted either by stapler (ST group, n = 8) or radiofrequency energy (RF group, n = 8). Both groups were compared for incidence of POPF and histopathological alterations of the pancreatic remnant. RESULTS: Six animals (75%) in the ST group and one (14%) in the RF group were diagnosed with POPF (p = 0.019). One animal in the RF group and three animals in the ST group had a pseudocyst in close contact with both pancreas stumps. On day 30 post-operation (PO), almost complete atrophy of the exocrine distal pancreas was observed when the main pancreatic duct was efficiently sealed. CONCLUSIONS: Our findings suggest that RF-induced heating is more effective at closing the pancreatic stump than mechanical stapler and leads to the complete atrophy of the distal remnant pancreas.
PURPOSE: The aim of this study was to assess the capacity of two methods of surgical pancreatic stump closure in terms of reducing the risk of pancreatic fistula formation (POPF): radiofrequency-induced heating versus mechanical stapler. MATERIALS AND METHODS: Sixteen pigs underwent a laparoscopic transection of the neck of the pancreas. Pancreatic anastomosis was always avoided in order to work with an experimental model prone to POPF. Pancreatic stump closure was conducted either by stapler (ST group, n = 8) or radiofrequency energy (RF group, n = 8). Both groups were compared for incidence of POPF and histopathological alterations of the pancreatic remnant. RESULTS: Six animals (75%) in the ST group and one (14%) in the RF group were diagnosed with POPF (p = 0.019). One animal in the RF group and three animals in the ST group had a pseudocyst in close contact with both pancreas stumps. On day 30 post-operation (PO), almost complete atrophy of the exocrine distal pancreas was observed when the main pancreatic duct was efficiently sealed. CONCLUSIONS: Our findings suggest that RF-induced heating is more effective at closing the pancreatic stump than mechanical stapler and leads to the complete atrophy of the distal remnant pancreas.
Authors: E Pueyo-Périz; C Téllez-Marquès; A Radosevic; O Morató; L Visa; L Ilzarbe; E Berjano; E de Vicente; I Poves; B Ielpo; L Grande; F Burdío; P Sánchez-Velázquez Journal: Sci Rep Date: 2022-05-06 Impact factor: 4.996