Department of Surgery, Kansai Medical University, 2-3-1 Shin-machi, Hirakata, Osaka, 573-1191, Japan.
J Hepatobiliary Pancreat Sci. 2011 Jul;18(4):609-14. doi: 10.1007/s00534-011-0370-0.
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.
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).
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.
The use of the new UCS was safe and associated with the economical benefit of fewer surgical stitches as well as reduced blood loss.
探讨新的超声刀（UCS）在保留幽门的胰十二指肠切除术（PD）治疗壶腹周围癌中的应用是否可以减少手术缝线数量、出血量和手术时间。
本研究纳入了 26 例连续接受 PD 治疗的壶腹周围癌患者。前瞻性收集了包括使用缝线数量在内的术中数据。将接受传统 PD（A 组）的 13 例患者的结果与接受 UCS 治疗的 13 例患者（B 组）进行比较。
两组患者的基线特征无显著差异。B 组出血量明显少于 A 组（p<0.0001）。尽管总手术时间无差异，但 B 组患者在肝门淋巴结清扫方面的时间明显短于 A 组（p=0.0189）。B 组患者使用的手术缝线数量明显少于 A 组（p<0.0001）。两组均未发生胰切除术后出血。
新超声刀的使用是安全的，并且具有经济优势，包括减少手术缝线数量和减少出血量。
