title: Effectiveness of LigaSure diathermy coagulation in liver surgery.
abstract: The principal cause of perioperative morbidity and mortality following hepatic resection is excessive intraoperative hemorrhage. This study evaluates the operative use of the LigaSure device in sealing ductal structures during major and minor hepatic resections. Patients were analyzed between June 1994 and December 2005, comparing 89 randomly selected cases undergoing hepatic resections using the clamp-crushing technique with LigaSure electrocautery and hepatic inflow occlusion where appropriate with 70 patients undergoing various hepatic resections using the clamp-crushing technique alone with hepatic inflow occlusion where appropriate. Intraoperative blood loss and perioperative blood transfusion requirements were significantly less for patients in the LigaSure group. LigaSure-assisted hepatic resection was generally performed more quickly than the conventional clamp-crushing technique. The overall maximum postoperative AST, ALT, and bilirubin serum levels were similar in the two groups, as was the incidence of major postoperative complications. The LigaSure device in this randomized study is safe and simple to use, resulting in less perioperative blood loss and transfusion requirement during hepatic parenchymal transection.
authors.affiliation: Department of General Surgery, European Institute of Oncology, University of Milan, Milan, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Chiappa
authors.forename: Emilio
authors.initials: E
authors.lastname: Bertani
authors.forename: Roberto
authors.initials: R
authors.lastname: Biffi
authors.forename: Andrew P
authors.initials: AP
authors.lastname: Zbar
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Viale
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Pruneri
authors.forename: Massimo
authors.initials: M
authors.lastname: Bellomi
authors.forename: Marco
authors.initials: M
authors.lastname: Venturino
authors.forename: Bruno
authors.initials: B
authors.lastname: Andreoni
mesh_terms: D000368:Aged; D004564:Electrocoagulation / Q000295:instrumentation* / Q000401:mortality* / Q000706:statistics & numerical data; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D006498:Hepatectomy / Q000295:instrumentation* / Q000401:mortality* / Q000706:statistics & numerical data; D006801:Humans; D007558:Italy; D008113:Liver Neoplasms / Q000175:diagnosis / Q000401:mortality* / Q000601:surgery*; D008297:Male; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D016019:Survival Analysis; D015996:Survival Rate; D016896:Treatment Outcome