Radiofrequency-induced heating versus mechanical stapler for pancreatic stump closure: in vivo comparative study

Abstract

Purpose: To assess the capacity of two methods of surgical pancreatic stump closure in terms of reducing the risk of pancreatic fistula formation (POPF): radiofrequencyinduced heating versus mechanical stapler. Materials and Methods: Sixteen pigs underwent a laparoscopic transection of the neck of the pancreas. Pancreatic anastomosis was always avoided in order to work with an experimental model prone to pancreatic fistula formation (POPF). Pancreatic stump closure was conducted either by stapler (ST Group, n=8) or radiofrequency energy (RF Group, n=8). Both groups were compared for incidence of POPF and histopathologic alterations of the pancreatic remnant. Results: Six animals (75%) in the ST Group and one (14%) in the RF Group were diagnosed of POPF (p=0.019). One animal in the RF Group and three animals in the ST Group had a pseudocyst in close contact with both pancreas stumps. On day 30 postoperative, almost complete atrophy of the exocrine distal pancreas was observed when the main pancreatic duct was efficiently sealed. Conclusions: Our findings suggest that RF-induced heating is more effective at closing the pancreatic stump than mechanical stapler and leads to the complete atrophy of the distal remnant pancreas.