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Decreasing Pancreatic Leak After Distal Pancreatectomy: Saline-coupled Radiofrequency Ablation in a Porcine Model

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Despite marked improvements in pancreatic surgery, the high incidence and morbidity of pancreatic leak after resection has remained unchanged. The objective of this study was to evaluate the role of saline-coupled radiofrequency ablation (TissueLink) as an alternative to traditional methods of stump closure in an animal model of distal pancreatectomy. Forty swine were randomized after pancreatic transection and remnant stump was either oversewn in a traditional fashion (control) or treated with the device alone (TissueLink). Animals were killed and necropsied at 3 or 5 weeks postoperatively. Primary endpoints were the development of a pancreatic fistula defined as dye extravasation from the remnant duct, presence of undrained amylase-rich fluid collections/abscess, and greater than threefold drain/serum amylase after the third postoperative day. The incidence of pancreatic leak in the TissueLink group was 5.5 vs 42% in the control group (p = 0.01). There were no differences in operative time or other clinical parameters measured. Histologic analysis of the remnant pancreatic stumps confirmed our results. These data support our hypothesis that saline-coupled radiofrequency ablation leads to obliteration of ducts with a resultant decrease in pancreatic leak and subsequent complications. This technology may play a substantial role in preventing this dreaded complication in the clinical setting.

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Acknowledgements

The authors would like to acknowledge the manufacturer of the device described in this manuscript (TissueLink Medical Inc.) for providing financial support for this study. However, they did not have any role in the design, implementation, or analysis of our results. Nor did they take part in the creation of this manuscript. The authors would also like to thank the following persons for contributing their valuable time and expertise in assisting us in this endeavor: The Department of Comparative Medicine, Naomi M. Gades, D.V.M., Wayne Kingsbury, Lorna A. Bowen, Stacy A. Hall, Renee L. Okerman, all the other members of the Animal Care Staff at the Institute Hills Research Facility, the 7MB Respiratory Technicians, and finally Steve Krage for his outstanding work ethic, dedication, and years of contribution to surgical animal research.

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Authors and Affiliations

  1. Department of Surgery, Mayo Clinic College of Medicine, 200 First Street SW, Mayo West 12, Rochester, MN, 55905, USA

    Mark J. Truty & Florencia G. Que

  2. Division of Trauma Critical Care and General Surgery, Mayo Clinic College of Medicine, Rochester, MN, USA

    Mark D. Sawyer

  3. Division of Gastrointestinal and General Surgery, Mayo Clinic College of Medicine, Rochester, MN, USA

    Florencia G. Que

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  1. Mark J. Truty
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  2. Mark D. Sawyer
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  3. Florencia G. Que
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Correspondence to Florencia G. Que.

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Truty, M.J., Sawyer, M.D. & Que, F.G. Decreasing Pancreatic Leak After Distal Pancreatectomy: Saline-coupled Radiofrequency Ablation in a Porcine Model. J Gastrointest Surg 11, 998–1007 (2007). https://doi.org/10.1007/s11605-007-0180-5

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