The use of water-jet dissection in open and laparoscopic liver resection.
BACKGROUND
We intend to give an overview of our experiences with the implementation of a new dissection technique in open and laparoscopic surgery.


METHODS
Our database comprises a total of 950 patients who underwent liver resection. Three hundred and fifty of them were performed exceptionally with the water-jet dissector. Forty-one laparoscopic partial liver resections were accomplished.


RESULTS
Using the water-jet dissection technique it was possible to reduce the blood loss, the Pringle- and resection time in comparison to CUSA and blunt dissection. In the last five years we could reduce the Pringle-rate from 48 to 6% and the last 110 liver resections were performed without any Pringle's manoeuvre. At the same time, the transfusion-rate decreased from 1.86 to 0.46 EC/patient. In oncological resections, the used dissection technique had no influence on long-time survival.


CONCLUSIONS
The water-jet dissection technique is fast, feasible, oncologically safe and can be used in open and in laparoscopic liver surgery.
Rau
H G
HG
Surgical Department of Visceral, Thoracic and Vascular Surgery, Amper-Klinikum Dachau, Dachau, Germany. gabriele.stichlmayr@amperkliniken.de
Duessel
A P
AP
Wurzbacher
S
S
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