Hepatic resection in 170 patients using saline-cooled radiofrequency coagulation.
BACKGROUND
Hepatic resection for malignancies or symptomatic benign liver lesions remains the standard of treatment. Historically, the principal cause of mortality during liver resection was intraoperative bleeding. Advances in surgical and anesthetic techniques, along with application of new technologies, have decreased blood loss and dramatically improved the outcomes for major liver surgery.


METHODS
The purpose of this prospective study was to determine the utility of a saline-cooled radiofrequency coagulation device (TissueLink Medical, Inc.) for hepatic resection. Intraoperative bleeding, blood transfusion, postoperative bile leak, and other complications were noted.


RESULTS
The results are described for 170 patients undergoing hepatic resection over a three-year period. There were no intraoperative or postoperative deaths. Six patients in the series received blood transfusions for a transfusion rate of 3.5%. Four patients experienced a transient postoperative bile leak. Three of the four closed spontaneously prior to discharge home, and the fourth closed promptly after ERCP. There were no episodes of postoperative hemorrhage, hepatic failure, liver abscess, or reoperation.


CONCLUSIONS
The saline-cooled radiofrequency coagulation device is very effective in achieving intraoperative hemostasis and facilitates liver parenchymal transection during hepatic resection.
Geller
David A
DA
UPMC Liver Cancer Center, Starzl Transplant Institute, Department of Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USA. gellerda@upmc.edu
Tsung
Allan
A
Maheshwari
Vivek
V
Rutstein
Lisa A
LA
Fung
John J
JJ
Marsh
J Wallis
JW