New technique in hepatic parenchymal transection for living related liver donor and liver neoplasms

Salvatore Gruttadauria, Cataldo Doria, Claudio H. Vitale, Lucio Mandala, Mario Magnone, John J. Fung, Ignazio R. Marino

Research output: Contribution to journalArticlepeer-review

Abstract

Background. Many different surgical techniques have been described for hepatic parenchymal transection. A retrospective analysis of perioperative mortality, length of hospitalization and blood transfused during operation in two patient groups undergoing liver resection was carried out. In group A, we developed a new technique to resect hepatic parenchyma, using an ultrasonic surgical aspirator with monopolar floating ball cautery, while in group B the crushing clamp technique was used. Methods. In all, 42 patients with liver resection were enrolled in group A and 107 resections in group B. All patients had hepatic neoplasms except for seven living transplant donors. In group A 43% of resections involved ≥3 segments and 57% involved ≤2 segments; in group B 36.4% involved ≥3 segments and 63.6% consisted of ≤2 segments. Statistical analysis utilised independent T square (Pearson Q square) and Mann-Whitney U test. Results. In group A 2.4% of patients died perioperatively, while 3.7% died in group B; mean length of stay (LOS) was 10.9 days in group B and 8.0 days in group A. The length of procedure was 7.5 h in group B and 6.7 h in group A. In group A, 79% did not undergo blood transfusion intraoperatively as opposed to 61% in group B. A mean of 0.5 U of blood was utilized in group A and 1.60 U in group B. Discussion. The new method of parenchymal transection seems to reduce the LOS, length of procedure and need for intraoperative blood transfusion.

Original languageEnglish
Pages (from-to)106-109
Number of pages4
JournalHPB
Volume6
Issue number2
DOIs
Publication statusPublished - 2004

Keywords

  • CUSA
  • Liver resection
  • Tissue link

ASJC Scopus subject areas

  • Gastroenterology

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