Pancreatic Transection with Cavitron Ultrasonic Surgical Aspirator versus Electrocautery in Pancreaticoduodenectomy for Prevention of Postoperative Pancreatic Fistula

Yasuyuki Suzuki, Keiichi Okano, Shinichi Yachida, Minoru Ohshima, Hirotaka Kashiwagi, Naoki Yamamoto, Shintaro Akamoto, Masao Fujiwara, Hisashi Usuki, Hideki Kamada, Hirohito Mori and Tsutomu Masaki

Departments of Gastroenterological Surgery, Kagawa University, Japan
Department of Gastroenterology, Kagawa University, Japan

^*Correspondance to: Yasuyuki Suzuki 

 PDF  Full Text DOI: 10.25107/2474-1647.1271

Abstract

Background: Postoperative pancreatic fistula (POPF) still remains a major cause of morbidity after pancreaticoduodenectomy (PD).Methods: This study enrolled only patients with a soft pancreas and compared two pancreatic transection devices, Cavitron ultrasonic surgical aspirator (CUSA) (group I, n=28) and electrocautery (group II, n=27), for the purpose of POPF prevention. We combined each transection technique with inner duct reconstruction with a stent and outer full-thickness pancreas-to-seromuscular jejunal anastomosis.Results: The incidence of Grade B POPF was lower in group I (21% versus 37%) but did not differ significantly. Grade C POPF and failure of the duct reconstruction were not observed in this series. Drain amylase levels higher than 5,000 IU/L on POD 1 and higher than 1,000 IU/L and 2,000 IU/L on POD 3 were significantly less common in group I (P=0.01 and P=0.04).Conclusion; Postoperative leak of pancreatic juice was more effectively controlled by the CUSA transection although clinical POPF incidence did not reduce significantly.

Keywords

CUSA, Pancreatic transaction; Pancreatic fistula; Pancreaticoduodenectomy

Cite the article

Suzuki Y, Okano K, Yachida S, Ohshima M, Kashiwagi H, Yamamoto N, et al. Pancreatic Transection with Cavitron Ultrasonic Surgical Aspirator versus Electrocautery in Pancreaticoduodenectomy for Prevention of Postoperative Pancreatic Fistula. Clin Surg. 2016; 1: 1271.