Pancreatic transection using a sharp hook-shaped ultrasonically activated scalpel

Abstract

Pancreatic transection using the sharp hook-shaped UAS is an easy and useful method that facilitates detection of the main pancreatic duct with minimal blood loss. It may contribute to lower morbidity and mortality after pancreatic resection.

Anatomy‐Specific Pancreatic Stump Management to Reduce the Risk of Pancreatic Fistula After Pancreatic Head Resection

“…However, such an anatomical situation would make more difficult a safe approximation between the pancreatic stump and the jejunal wall, especially in its posterior corner, and would likely result in pancreatic fistula. Pancreatic stump management for reducing the risk of pancreatic fistula and subsequent septic complications after pancreatic head resection may involve some or all of the Values in parentheses are percentages of row totals a Patients who lacked clinical evidence of fistula-no fistula or Grade A fistula following devices and procedures: the use of ultrasonically activated shears [27] or an ultrasonic dissector [28,29] during pancreas transection, optimizing the blood supply to the pancreas [30], duct-to-mucosa pancreaticoenteric anastomosis [31][32][33][34], dunking pancreatojejunostomy [19,25,35], pancreaticogastrostomy [16,25,33,36,37], use of a pancreatic duct stent [38], omental wrapping of skeletonized major vessels [39,40], or intraoperative octreotide administration via the gastroduodenal artery [41]. In the present study, we modified the outer-layer interrupted suture technique according to the anatomical status of each pancreatic remnant.…”

Diagnosis and management of insulinoma

“…Lymphadenectomy is not usually performed. Although the cure rate after resection for insulinoma is very high, it is necessary to be aware of the potential for postoperative complications after pancreatic surgery, especially postoperative pancreatic fistula [64][65][66] .…”