LAPAROSCOPIC DISTAL PANCREATECTOMY IN THE PIG USING ULTRASONIC DISSECTOR DEVICE

Objective: To analyse in a porcine model the outcome of laparoscopic d istal pancreatectomy using an ultrasonic dissection device. Design and subjects: Six week survival study in Suabian Hall landrace pigs. Inte rventions: Laparoscopic distal pancreatectomy using an ultrasonic diss ection device. Main outcome measures: Analysis of inflammatory respons e, healing complications and tissue injury. Results: in four of five a nimals the left pancreatic segment was resected via the laparoscopic a pproach, 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 t he 6-week observation period without signs of fistula or infection. Th ere was no increase of WBC count and serum p-amylase during post-opera tive follow up, indicating absence of systemic inflammatory response a nd local tissue injury. Histomorphologic analysis of the pancreatic st ump 6 weeks after ultrasonic resection confirmed intact pancreatic aci nar tissue without signs of inflammation or fibrosis/necrosis. Conclus ion: We propose that laparoscopic resection of the left pancreatic seg ment with the ultrasonic dissector represents a promising new approach for distal pancreatectomy.