Distal pancreatectomy using the harmonic scalpel

Comparison of ultrasonically activated scalpel versus conventional division for the pancreas in distal pancreatectomy

“…In our series, the postoperative serum amylase levels were significantly lower in the US group. The use of the US were considered to reduce the damage to the remnant pancreas, due to its excellent coagulation‐cutting effect 9,11. Actually, no bleeding was observed on the cut surface in the US group, and, therefore, no clamping or parenchymal suturing was needed for hemostasis.…”

“…The splenic artery and vein were ligated and divided proximally to the plane of the pancreatic dissection. Subsequent procedures in the US group have been described previously 9. Briefly, the pancreas parenchyma was divided using the US, with coagulation shears forming the handpiece of the instrument.…”

“…The mean serum amylase values and the incidence of pancreatic fistula in the US group and the CV group were then compared. Postoperative pancreatic fistula was diagnosed according to the previously described criteria 9. These criteria were: external discharge of pancreatic fluid for more than 7 postoperative days or a high concentration of amylase in the drainage fluid (more than three times the serum concentration) on the seventh postoperative day 8,10…”

RETRACTED ARTICLE: Preoperative endoscopic pancreatic stenting: a novel prophylactic measure against pancreatic fistula after distal pancreatectomy

“…Pancreatic fistula is a common complication of distal pancreatectomy (DP) . The incidence of pancreatic fistula after DP ranges from 5% to 60% . Recent advances in medical and surgical care in DP cannot completely eliminate the possibility of pancreatic fistula development.…”

Frey?s Procedure Using the Harmonic Scalpel

“…6 Using the harmonic scalpel has been found to reduce the risk of pancreatic fistula in patients undergoing distal pancreatectomy. 7 In conclusion, the harmonic scalpel makes Frey's procedure quicker, simpler, and less traumatic. Although it was originally designed for laparoscopic surgery, because of its distinct advantages the harmonic scalpel is being increasingly used in other operations such as hepatic resections and pelvic procedures.…”