Simplified hepatic resections with the use of a Chang's needle.
OBJECTIVE
To demonstrate the use of Chang's needle for hepatic resections.


BACKGROUND
Specialized instruments, fine surgical skills, and good control of hepatic inflow and backflow are essential for hepatic resections. This needle was specifically designed to simplify these requirements.


METHODS
Whole-thickness interlocking sutures of the liver can first be made along the designed resection line with a Chang's needle; then parenchyma transection can follow without inflow or backflow control. This was consecutively performed on 69 patients with primary (41), metastatic (10), and benign (18) diseases since 1997.


RESULTS
Blood loss during parenchyma transection was reduced in 11 right lobectomies (652 mL), 1 3-segmentectomy (300 mL), 14 bisegmentectomies (252 mL), 7 segmentectomies (104 mL), 12 subsegmentectomies (19 mL), 5 wedge resections (7 mL), 18 left lateral segmentectomies (110 mL), and 1 hepatorrhaphy (minimal). There was no procedure-related mortality. A mild bile leakage occurred in 1 case (1.5%) but healed spontaneously.


CONCLUSIONS
The preliminary results demonstrate that this maneuver is a simple, easy, and safe method for performing hepatic resections.
Chang
Yu-Chung
YC
Department of Surgery, College of Medicine, National Cheng Kung University, Tainan, Taiwan. changyc@mail.ncku.edu.tw
Nagasue
Naofumi
N
Chen
Chu-San
CS
Lin
Xi-Zhang
XZ
D016063:Blood Loss, Surgical / Q000517:prevention & control; D004322:Drainage; D004867:Equipment Design; D006498:Hepatectomy / Q000295:instrumentation*; D006801:Humans; D008107:Liver Diseases / Q000601:surgery*; D009339:Needles; D013536:Suture Techniques; D016896:Treatment Outcome