JOURNAL OF SURGICAL ONCOLOGY 102, 2, 179 - 183 (2010).
Usefulness of the Combination Procedure of Crash Clamping and Vessel Sealing for Hepatic Resection
Atsushi Nanashima , Syuuichi Tobinaga , Takafumi Abo , Takashi Nonaka , Terumitsu Sawai , Takeshi Nagayasu
Background: Minimization of blood loss during resection of the hepatic parenchyma in hepatectomy remains a major problem. The usefulness of the LigaSure sealing system has been reported. Objectives: To evaluate the efficacy of combination procedure of LigaSure and forceps clamping for control blood loss and transection time in hepatectomy. Methods: Here, we report our experience with the combination technique of LigaSure Precise (TM), a clamp forceps type, and crush clamping method for hepatic transection in 33 patients who underwent hepatectomy. Results: The combination technique allows fast and bloodless transection even along the major intrahepatic vessels. Blood loss and transection time were significantly reduced in the group of LigaSure use (P < 0.05). Efficient hemostasis could be achieved also in patients with extensive liver injury such as cirrhosis. The rates of postoperative intraabdominal abscess formation in the combination technique of LigaSure and crush clamping were lower compared with the conventional crush clamping method (P < 0.05). Conclusions: The combined use of LigaSure Precise (TM) and crush clamping technique is safe and allows rapid completion of hepatic resection. J. Surg. Oncol. 2010;102:179-183. (C) 2010 Wiley-Liss, Inc.