• Faik G Uzunoglu, Anne Stehr, Judith A Fink, Eik Vettorazzi, Alexandra Koenig, Karim A Gawad, Yogesh K Vashist, Asad Kutup, Oliver Mann, Francesca Gavazzi, Alessandro Zerbi, Claudio Bassi, Christos Dervenis, Marco Montorsi, Maximilian Bockhorn, and Jakob R Izbicki.
• Department of General, Visceral and Thoracic Surgery, University Medical Centre Hamburg-Eppendorf, Martinistraße 52, Hamburg, Germany.
• Ann. Surg. 2012 Nov 1; 256 (5): 675-9; discussion 679-80.

Objective: This prospective randomized multicenter trial was performed to assess the potential benefits of ultrasonic energy dissection compared with conventional dissection techniques in pancreatic surgery.Background: 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.Methods: 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.Results: 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.Conclusions: Tissue dissection and vessel closure using an ultrasonic device is equivalent to dissection with conventional techniques in pancreatic surgery.

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