[The value of TissueLink hemostatic sealer in hepatectomy for hepatocellular carcinoma].
OBJECTIVE
Managing the liver stumps reliably is an important guarantee for the accomplishment of hepatectomy. This study was to explore the value of TissueLink hemostatic sealer in hepatectomy for hepatocellular carcinoma (HCC), and evaluate its effects in extending incisal edge and reducing recurrence rate.


METHODS
TissueLink hemostatic sealer was used on the liver stumps during hepatectomy for 20 patients (study group); whereas, conventional suturing of the vessels and bile ducts was performed in 28 patients (control group). Peri-operative serum alanine aminotransferase (ALT), total bilirubin, hospitalization period and complication occurrence were observed and compared.


RESULTS
The amount of operative bleeding and the amount of post-operative abdominal cavity drainage were significantly lower in study group than in control group [(412.50+/-122.34) ml vs. (530.36+/-151.13) ml, P=0.006; (285.50+/-43.59) ml vs. (347.86+/-67.62) ml, P=0.001]. Three and 7 days after operation, serum ALT levels were significantly lower in study group than in control group [(152.36+/-93.32) U/ml vs. (246.19+/-159.85) U/ml, P=0.015; (56.63+/-21.59) U/ml vs. (96.46+/-47.97) U/ml, P=0.009]; serum total bilirubin levels were significantly lower in study group than in control group [(25.93+/-9.63) micromol/L vs. (40.12+/-16.54) micromol/L, P=0.004; (17.25+/-7.22) micromol/L vs. (39.63+/-19.06) micromol/L, P=0.001]. Hospitalization period was significantly shorter in study group than in control group [(10.5+/-1.5) days vs. (12.9+/-2.8) days, P=0.002]. The occurrence rate of complications was lower in study group than in control group. On CT image after operation, an annular zone of necrosis in the liver was found in most patients of study group.


CONCLUSIONS
TissueLink hemostatic sealer is a safe device to manage the liver stumps in hepatectomy. It has less damage on liver function after operation, and can shorten hospitalization period and reduce the occurrence of post-operative complications.
Wei
Wei
W
State Key Laboratory of Oncology in South China, Guangzhou, Guangdong, 510060, P. R China.
Guo
Rong-Ping
RP
Shi
Ming
M
Zhong
Chong
C
Yu
Wu-Sheng
WS
Li
Jin-Qing
JQ
D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D001663:Bilirubin / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000601:surgery*; D005260:Female; D006488:Hemostasis, Surgical / Q000295:instrumentation*; D006498:Hepatectomy / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D007902:Length of Stay; D008113:Liver Neoplasms / Q000097:blood / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications
D000410:Alanine Transaminase; D001663:Bilirubin