Laparoscopic distal pancreatectomy in the pig using ultrasonic dissector device

Summary

Objective: To analyse in a porcine model the outcome of laparoscopic distal pancreatectomy using an ultrasonic dissection device. Design and subjects: Six week survival study in Suabian Hall landrace pigs. Interventions: Laparoscopic distal pancreatectomy using an ultrasonic dissection device. Main outcome measures: Analysis of inflammatory response, healing complications and tissue injury. Results: In four of five animals the left pancreatic segment was resected via the laparoscopic approach, preserving the spleen and splenic vessels. In one animal the operative procedure had to be converted to open access surgery due to bleeding from the splenic vein with resection of the spleen and distal pancreatectomy using the ultrasonic dissector. All animals survived the 6-week observation period without signs of fistula or infection. There was no increase of WBC count and serum p-amylase during post-operative follow up, indicating absence of systemic inflammatory response and local tissue injury. Histomorphologic analysis of the pancreatic stump 6 weeks after ultrasonic resection confirmed intact pancreatic acinar tissue without signs of inflammation or fibrosis/necrosis. Conclusion: We propose that laparoscopic resection of the left pancreatic segment with the ultrasonic dissector represents a promising new approach for distal pancreatectomy.

Keywords:

• endoscopic surgery
• distal pancreatectomy
• ultrasonic dissector
• pancreatic stump closure
• pigs