Incidence of bile leakage after three types of hepatic parenchymal transection.
OBJECTIVE
Bile leakage is a major morbidity associated with hepatectomies. No study has been performed correlating various methods of liver transection to incidences of bile leakage.


METHODS
The 89 patients with hepatocellular carcinoma who received hepatectomy were classified into 3 groups according to the specific method of liver resection: cavitron ultrasonic surgical aspirator (CUSA), microwave tissue coagulation (MTC), and clamp crushing (CC). Comparisons in the incidences of bile leakage and length of hospital stay were made among these groups.


RESULTS
The CC group showed a significantly lower incidence of bile leakage than the MTC group (3% vs. 27%, P = 0.03). In the median postoperative hospitalization length, the CC group demonstrated a significantly shorter period than that in the MTC group (25 vs. 35 days, P = 0.03). No significant differences were found for operation time, amount of blood loss or resected tumor size in the 3 groups.


CONCLUSIONS
In view of the incidence of bile leakage, CC is a favorable technique for hepatectomy.
First Department of Surgery, Nihon University School of Medicine, Tokyo, Japan. hnakayam@med.nihon-u.ac.jp
Hisashi
H
Nakayama
Hideki
H
Masuda
Masahiko
M
Shibata
Sadao
S
Amano
Masahiro
M
Fukuzawa
D000328:Adult; D000368:Aged; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012307:Risk Factors