Department of General, Visceral and Thoracic Surgery, University Medical Centre Hamburg-Eppendorf, Martinistraße 52, Hamburg, Germany.
Ann Surg. 2012 Nov;256(5):675-9; discussion 679-80. doi: 10.1097/SLA.0b013e318271cefa.
: This prospective randomized multicenter trial was performed to assess the potential benefits of ultrasonic energy dissection compared with conventional dissection techniques in pancreatic surgery.
: Surgical procedures for tumors of the pancreatic head involve time-consuming manual dissection. The primary hypothesis was that use of ultrasonic tissue and vessel dissection would lead to substantial saving in operative time during pancreatic resection.
: Patients eligible for pancreaticoduodenectomy (PD) or pylorus-preserving PD (PPPD) were randomized to group A (dissection with ultrasonic device) or group B (conventional dissection) from March 2009 to May 2011. The primary endpoint was overall duration of operation time. Secondary endpoints were time to end of resection phase, intraoperative blood loss, number of transfused units of blood, and postoperative morbidity.
: Analysis of primary and secondary endpoints included 101 patients, who received either PD or PPPD. Demographical characteristics and clinical parameters were similar in both groups. The use of an ultrasonic dissection device did not significantly reduce overall operation time (median 316 minutes in group A and 319 minutes in group B, P = 0.95) and did not significantly increase the costs of surgery. Analysis of secondary endpoints revealed no difference in postoperative course.
: Tissue dissection and vessel closure using an ultrasonic device is equivalent to dissection with conventional techniques in pancreatic surgery.
本前瞻性随机多中心试验旨在评估与传统分离技术相比，超声能量分离在胰腺手术中的潜在益处。
胰腺头部肿瘤的手术程序涉及耗时的手动分离。主要假设是使用超声组织和血管分离将导致胰腺切除术中手术时间的大量节省。
从 2009 年 3 月至 2011 年 5 月，符合胰十二指肠切除术（PD）或保留幽门 PD（PPPD）条件的患者被随机分为 A 组（超声设备分离）或 B 组（常规分离）。主要终点是手术时间的总持续时间。次要终点是切除阶段结束时间、术中失血量、输血量和术后发病率。
对主要和次要终点的分析包括 101 名接受 PD 或 PPPD 的患者。两组患者的人口统计学特征和临床参数相似。使用超声分离装置不会显著减少总手术时间（A 组中位数 316 分钟，B 组中位数 319 分钟，P = 0.95），也不会显著增加手术成本。对次要终点的分析显示术后过程无差异。
在胰腺手术中，使用超声设备进行组织分离和血管闭合与传统技术相当。
