Background Endopancreatic surgery (EPS) is an experimental minimally invasive technique for resection of pancreatic tissue from inside the pancreatic duct, accessed via the duodenum and papilla. It is proposed as an alternative to duodenum- preserving pancreatic head resection in benign diseases such as chronic pancreatitis (CP). This study evaluated the use of EPS for resection of pancreatic duct stenoses. Moreover, greenlight laser (GLL) and monopolar electrosurgical device (MES) were compared as resection tools for EPS. Methods The suitability of EPS for resection of stenoses was evaluated in ex vivo bovine pancreas (n = 8). Artificially cre- ated stenoses in the pancreatic head were accessed via the duodenal papilla and resected from inside the organ with MES through a rigid endoscope. Furthermore, standardized pancreatic resections were performed in an in vivo porcine model using either GLL (n = 18) or MES (n = 18) to compare blood loss, operating time, and complications. Thermal damage to the surrounding tissue was assessed using a standardized histological classification. Results Stenosis resection by EPS was feasible in 8/8 bovine pancreases, with a procedure time of 17 (12–24) min. No per- foration of the organ occurred. Resection by GLL was associated with reduced blood loss [median 1.7
Surgical Endoscopy – Springer Journals
Published: May 1, 2018
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