Aims. Different surgical transection methods have been used for distal pancreatectomy (DP), but none of them has yet achieved perfect results. This study compares 2 standard transection techniques with the alternative LigaSure technique. Methods. Forty-eight pigs underwent a DP. Sixteen animals were operated on with a scalpel followed by hand suturing. Sixteen pigs received a DP using an Endo GIA, and the pancreas of 16 pigs was transected with LigaSure. The transection surface of remnant pancreas was observed for liquid collection and abscess on postoperative day 7. Results. Operating time on the day of DP was significantly different, with a shorter operating time in the stapler and LigaSure groups. The morbidity on postoperative day 7 was similar in all groups. Conclusion. In the present experimental animal study, LigaSure seems to be fast and safe as well as comparable with the standard transection and closure techniques in DP.
PannegeonVPessauxPSauvanetAVulliermeMPKianmaneshRBelghitiJ. Pancreatic fistula after distal pancreatectomy: predictive risk factors and value of conservative treatment. Arch Surg. 2006;141:1071-1076.
2.
GohBKTanYMChungYF. Critical appraisal of 232 consecutive distal pancreatectomies with emphasis on risk factors, outcome, and management of the postoperative pancreatic fistula. Arch Surg. 2008;143:956-965.
3.
KleeffJDienerMKZ’graggenK. Distal pancreatectomy risk factors for surgical failure in 302 consecutive cases. Ann Surg. 2007;245:573-582.
4.
FerroneCRWarshawALRattnerDW. Pancreatic fistula rates after 462 distal pancreatectomies: staplers do not decrease fistula rates. J Gastrointest Surg. 2008;12:1691-1697.
5.
OkanoKKakinokiKYachidaSIzuishiKWakabayashiHSuzukiY. A simple and safe pancreas transection using a stapling device for a distal pancreatectomy. J Hepatobiliary Pancreat Surg. 2008;15:353-358.
6.
BilimoriaMMCormierJNMunYLeeJEEvansDBPistersPW. Pancreatic leak after left pancreatectomy is reduced following main pancreatic duct ligation. Br J Surg. 2003;90:190-196.
7.
TepetesKChristodoulidisGSpyridakisEMChatizitheofilouC. Tissue preserving hepatectomy by a vessel sealing device. J Surg Oncol. 2008;97:165-168.
8.
CheangTHannaSSWrightFCLawCH. Use of a collagen-sealing device in hepatic resection: a comparative analysis to standard resection technique. HPB (Oxford). 2006;8:194-199.
9.
EttingerJERamosACÁzaroE. Staplerless laparoscopic gastric bypass: a new option in bariatric surgery. Obes Surg. 2006;16:638-645.
10.
FingerhutAVeyrieNAtaTAlexakisNLeandrosE. Use of sealants in pancreatic surgery: critical appraisal of the literature. Dig Surg. 2009;26:7-14.
11.
FrillingAStavrouGAMischingerHJ. Effectiveness of a new carrier-bound fibrin sealant versus argon beamer as haemostatic agent during liver resection: a randomised prospective trial. Lagenbecks Arch Surg. 2005;390:114-120.
12.
AneggULindenmannJMatziVSmolleJMaierASmolle-JüttnerF. Efficiency of fleece-bound sealing (TachoSil) of air leaks in lung surgery: a prospective randomised trial. Eur J Cardiothorac Surg. 2007;31: 198-202.
13.
SiemerSLahmebSAltzieblerS. Efficacy and safety of TachoSil as haemostatic treatment versus standard suturing in kidney tumour resection: a randomised prospective study. Eur Urol. 2007;52:1156-1163.
14.
FisherWEChaiCHodgesSEWuMFHilsenbeckSGBrunicardiFC. Effect of BioGlue on the incidence of pancreatic fistula following pancreas resection. J Gastrointest Surg. 2008;12:882-890.
15.
RosenMWalshRMGoldblumJR. Application of a new collagen-based sealant for the treatment of pancreatic injury. Surg Laparosc Endosc Percutan Tech. 2004;14:181-185.
16.
VelanovichV. The use of tissue sealant to prevent fistula formation after laparoscopic distal pancreatectomy. Surg Endosc. 2007;21:1222.
17.
BassiCDevernisCButturiniG. Postoperative pancreatic fistula: an international study group (ISGPF) definition. Surgery. 2005;138:8-13.
18.
SlomovitzBMRamirezPTFrumovitzM. Electrothermal bipolar coagulation for pelvic exenterations. Gynecol Oncol. 2006;102:534-536.
19.
ErogluATurkyilmazAAydinYErdemAFTokurMKaraoglanogluN. The use of the Ligasure Vessel Sealing System in esophageal cancer surgery. Ann Thorac Surg. 2007;84:2076-2080.
20.
FronzaJSBentremDJBakerMSTalamontiMSUjikiMB. Laparoscopic distal pancreatectomy using radiofrequency energy. Am J Surg. 2010;199:401-404.
21.
SenguptaSWebbDR. Use of a computer-controlled bipolar diathermy system in radical prostatectomies and other open urological surgery. ANZ J Surg. 2001;71: 538-540.
22.
YoussefTMahdyTFaridMLatifAA. Thyroid surgery: use of the Ligasure Vessel Sealing System versus conventional knot tying. Int J Surg. 2008;6:323-327.
23.
KnaebelHPDienerMKWenteMNBüchlerMWSeilerCM. Systematic review and meta-analysis of technique for closure of the pancreatic remnant after distal pancreatectomy. Br J Surg. 2005;92:539-546.
24.
SartoriCABaiocchiGL. Transecting the pancreas neck with electrothermal bipolar vessel sealer (LigaSure) in laparoscopic left pancreatectomy: case report. Surg Laparosc Endosc Percutan Tech. 2009;19:e175-e176.
