Hepatic resection using a water jet dissector.
The mortality and morbidity in major hepatic resection is often related to hemorrhage. A high pressure, high velocity water jet has been developed and has been utilized to assist in hepatic parenchymal transection. Sixty-seven major hepatic resections were performed for solid hepatic tumors. The tissue fracture technique was used in 51 patients (76%), and the water jet dissector was used predominantly in 16 patients (24%). The extent of hepatic resection using each technique was similar. The results showed no difference in operative duration (p = .499). The mean estimated blood loss using the water jet was 1386 ml, and tissue fracture technique 2450 ml (p = .217). Transfusion requirements were less in the water jet group (mean 2.0 units) compared to the tissue fracture group (mean 5.2 units); (p = .023). Results obtained with the new water dissector are encouraging. The preliminary results suggest that blood loss may be diminished.
Baer
H U
HU
Clinic for Visceral and Transplantation Surgery, Inselspital, University of Berne, Switzerland.
Stain
S C
SC
Guastella
T
T
Maddern
G J
GJ
Blumgart
L H
LH
D002759:Adenoma, Bile Duct / Q000556:secondary / Q000601:surgery; D000328:Adult; D001650:Bile Duct Neoplasms; D001658:Biliary Fistula / Q000209:etiology; D016063:Blood Loss, Surgical; D001803:Blood Transfusion; D006528:Carcinoma, Hepatocellular / Q000601:surgery; D004210:Dissection / Q000009:adverse effects / Q000295:instrumentation*; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006498:Hepatectomy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary / Q000601:surgery; D008297:Male; D008875:Middle Aged; D015996:Survival Rate; D013997:Time Factors; D014867:Water
D006454:Hemoglobins; D014867:Water