Ultrasonically activated device for parenchymal division during open hepatectomy.
BACKGROUND
The use of new technological devices has gained popularity and has been proposed to improve the safety of liver resection. This study was designed to evaluate the usefulness of the ultrasonically activated device (USAD) during open liver resection.


METHODS
Indication for surgery, type of resection, need to perform a Pringle manoeuvre, operation time, blood loss, number of blood transfusions, morbidity and mortality rate were analyzed in 60 patients undergoing a formal open liver resection by means of USAD.


RESULTS
The overall mean operation time was 172 minutes (range 120-255 min); an intermittent warm ischemia was applied in 9 cases (15%). The overall mean blood loss was 410 mL (median 400 mL, range 50-950 ml). A median of one blood transfusion was administered in six patients (10%). The mean hospital stay was 10.2 days (median 11, range 8-16). The overall morbidity rate was 20% (12 out of 60 patients). No in-hospital mortality was recorded. By subdividing the patients according to the presence or absence of cirrhosis no statistical significant differences were found between the two subgroups in all peri-and postoperative outcomes.


CONCLUSIONS
In conclusion, though there is a lack of data based on well conducted controlled studies and further on a greater number of patients are needed, the utilization of USAD may help to minimize blood loss during liver resection regardless of the condition of the liver, even in case of cirrhosis.
Belli
G
G
Department of General and Hepato-Pancreato-Biliary Surgery, S. M. Loreto Nuovo Hospital, Via A. Vespucci, Naples, Italy. chirurgia.loretonuovo@tin.it
Limongelli
P
P
Belli
A
A
Fantini
C
C
D'Agostino
A
A
Cioffi
L
L
Russo
G
G
Am Surg. 2000 Nov;66(11):1037-40
11090014
Ann Surg. 2002 Jan;235(1):27-30
11753039
Eur J Surg Oncol. 2007 Oct;33(8):1036-41
17369004
J Gastrointest Surg. 1999 Sep-Oct;3(5):537-42
10482712
Surg Endosc. 2007 Nov;21(11):2004-11
17705086
Hepatogastroenterology. 2005 Jan-Feb;52(61):173-5
15783022
J Hepatobiliary Pancreat Surg. 2006;13(2):149-54
16547677
Dig Surg. 2007;24(4):259-64
17657150
J Laparoendosc Adv Surg Tech A. 1999 Feb;9(1):63-7
10194695
Zentralbl Chir. 1999;124(2):163-6
10209851
Surgery. 1996 Nov;120(5):852-8
8909521
Hepatogastroenterology. 2009 Jan-Feb;56(89):236-9
19453065
HPB (Oxford). 2006;8(5):377-85
18333091
Dig Surg. 2000;17(2):138-42
10781976
World J Surg. 1999 Oct;23(10):1032-7
10512943
Ann Surg. 2002 Nov;236(5):560-3
12409660
Am J Surg. 1986 Mar;151(3):368-73
3953957
HPB (Oxford). 2005;7(3):208-13
18333192
Zentralbl Chir. 1998;123(6):746-51
9703649
J Hepatobiliary Pancreat Surg. 2002;9(5):607-13
12541048
J Endourol. 1998 Oct;12(5):441-4
9847067