Rapid recovery of postoperative liver function after major hepatectomy using saline-linked electric cautery.
OBJECTIVE
The exact effect of heat injury in the residual liver on postoperative liver function is not totally understood. The purpose of this study was to compare postoperative liver function after major liver resection using an argon laser beam coagulator (AR) and that using saline-linked electric cautery (SLC) for vessels and bile duct sealing.


METHODS
Between January 2001 and December 2005, thirty patients were analyzed in this study retrospectively. The inclusion criteria were that the patients received hemihepatectomy without vascular and biliary reconstruction in a non-cirrhotic liver. Operative variables and liver functions were compared between the AR method and the SLC method.


RESULTS
The clinical profiles of the two groups were almost identical, including preoperative hepatic function. Although there was no difference in most of the intraoperative variables between them, warm ischemic time in the SLC group was shorter than in the AR group (46.53 + 25.42 min vs. 70.47 +/- 11.48 min: p=0.003). Albumin and bilirubin levels at 7 days after hepatectomy were not significantly different between the two groups, but low-density lipoprotein (LDL) and apolipoprotein B (ApoB) levels in the SLC group at 7 days after hepatectomy were significantly higher than in the AR group (84.27 +/- 14.38 mg/dl vs. 60.21 +/- 14.27 mg/dl: p=0.001; 69.53 +/- 17.18 mg/dl vs. 55.87 +/- 9.56 mg/dl: p=0.012, respectively).


CONCLUSIONS
SLC reduces warm ischemic time during hepatectomy. Furthermore, the rapid recovery of LDL and ApoB levels in the SLC group indicates that the SLC method has potential benefits for postoperative hepatic function.
Mizuguchi
Toru
T
Department of Surgery I, Sapporo Medical University Hospital, Sapporo Medical University, S-1, W-16, Chuo-Ku, Sapporo, Hokkaido 060-8543, Japan. tmizu@sapmed.ac.jp
Katsuramaki
Tadashi
T
Nagayama
Minoru
M
Meguro
Makoto
M
Shibata
Toshihito
T
Kaji
Shinsuke
S
Hirata
Koichi
K
D004564:Electrocoagulation; D005260:Female; D006498:Hepatectomy / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D008099:Liver / Q000503:physiopathology*; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D020127:Recovery of Function; D012189:Retrospective Studies; D013997:Time Factors