Use of the new ultrasonically curved shear in pancreaticoduodenectomy for periampullary cancer.

摘要

OBJECTIVES: To examine whether the use of the new ultrasonically curved shear (UCS) can reduce the number of surgical stitches, extent of blood loss, and operation time in (pylorus-preserving) pancreaticoduodenectomy (PD) for periampullary cancer. METHODS: The study population comprised 26 consecutive patients who underwent PD for periampullary cancer. Intraoperative data, including number of stitches used, was prospectively collected. Results from 13 patients who underwent conventional PD (Group A) were compared with those from 13 patients who underwent PD using UCS (Group B). RESULTS: There were no significant differences in baseline characteristics between the two patient groups. The extent of blood loss in Group B was significantly less than in Group A (p < 0.0001). Although there was no difference in total operation time, the time spent on hilar lymph node dissection was significantly shorter in Group B patients than in Group A patients (p = 0.0189). The number of surgical stitches used was significantly less in Group B patients than in Group A patients (p < 0.0001). There were no incidences of post-pancreatectomy hemorrhage. CONCLUSION: The use of the new UCS was safe and associated with the economical benefit of fewer surgical stitches as well as reduced blood loss.