The vascular stapler in uncinate process division during pancreaticoduodenectomy: technical considerations and results

Dig Surg. 2010 Aug;27(3):175-81. doi: 10.1159/000264674. Epub 2010 Jun 22.

Abstract

Background: Few studies describing the use of stapling devices for uncinate process division during pancreaticoduodenectomy (PD) have data regarding outcomes. Our aim is to discuss our technique and the peri-operative outcomes with the use of the linear vascular stapler for division of the uncinate process during PD.

Materials and methods: 19 consecutive patients who underwent stapler division of the uncinate process ('stapler' group) were compared to 20 consecutive patients operated without stapler ('no-stapler' group).

Results: The overall surgical morbidity in the no-stapler group was 25% (5/20) and 31.6% (6/19) in the stapler group (p = 0.731). The mean blood loss in the no-stapler group was 1,077.5 +/- 594 ml compared to 778 +/- 302 ml in the stapler group (p = 0.113). The mean operative duration was 498 +/- 105 min in the no-stapler group and 490 +/- 60 min in the stapler group (p = 0.773). The average number of lymph nodes retrieved was 6.1 +/- 3 in the no-stapler group versus 5.9 +/- 4 in the stapler group (p = 0.627). Neither group had positive resection margins.

Conclusion: Stapler division of the uncinate process for selected periampullary tumours compares well with the conventional method, has comparable peri-operative outcomes without compromising oncological radicality and has the potential to simplify uncinate resection.

Publication types

  • Comparative Study

MeSH terms

  • Blood Loss, Surgical / prevention & control
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pancreas / surgery*
  • Pancreatic Neoplasms / surgery
  • Pancreaticoduodenectomy / methods*
  • Prospective Studies
  • Surgical Staplers*