Publication

Dissection with LigaSure Impact™ versus conventional resection in pylorus-preserving partial pancreatoduodenectomy (DISSECT): a single-institution randomized controlled trial

Journal Paper/Review - Aug 22, 2020

Units
Keywords
Blood Loss, Surgical
Dissection
Humans
Operative Time
*Pancreatectomy
*Pancreaticoduodenectomy
*Pylorus/surgery
Treatment Outcome
Conventional dissection
LigaSure impact
Operation time
Pylorus-preserving partial pancreatoduodenectomy
PubMed
Doi
Link
Contact

Citation
Gehrig T, Josef V, Billeter A, Warschkow R, Knebel P, Gutt C, Diener M, Tarantino I. Dissection with LigaSure Impact™ versus conventional resection in pylorus-preserving partial pancreatoduodenectomy (DISSECT): a single-institution randomized controlled trial. Langenbecks Arch Surg 2020; 405:949-958.
Project
Type
Journal Paper/Review (English)
Journal
Langenbecks Arch Surg 2020; 405
Publication Date
Aug 22, 2020
Issn Print
Issn Electronic
1435-2451
Pages
949-958
Publisher
Brief description/objective

PURPOSE
In partial pancreatoduodenectomy, appropriate effective hemostasis during dissection is of major importance for procedural flow, operation time, and postoperative outcome. As ligation, clipping, or suturing of blood vessels is time-consuming and numerous instrument changes are required, the primary aim of this randomized controlled trial was to assess whether LigaSure Impact™ exhibits benefits over named conventional dissection techniques in patients undergoing pylorus-preserving partial pancreatoduodenectomy.

METHODS
This single-institution, randomized, superiority trial was performed between September 27, 2009, and February 24, 2012. Patients undergoing pylorus-preserving partial pancreatoduodenectomy were allocated to the study arms in a 1:1 ratio based on an unstratified block randomization with random block sizes to receive either dissection with LigaSure Impact™ or conventional dissection. The primary endpoint was operation time. Secondary endpoints included peri- and postoperative morbidity and mortality, intraoperative blood loss, and length of hospital stay. To observe a time reduction of 40 min, 51 patients per arm were required. The primary analysis was the intention to treat.

RESULTS
The mean operation time did not differ between the Ligasure Impact™ (308 min; SD: 56 min; range: 155-455 min) and the conventional dissection (318 min; SD: 90 min, range: 175-550 min) (p = 0.531). Moreover, LigaSure Impact™ dissection did not show significant advantages over conventional dissection in terms of peri- and postoperative morbidity and mortality, intraoperative blood loss, or length of hospital stay.

CONCLUSIONS
The application of LigaSure Impact™ dissection in pylorus-preserving partial pancreatoduodenectomy does not increase effectiveness and safety of dissection.

TRIAL REGISTRATION
DRKS00000166.