Vascular transection using endovascular stapling in hepatic resection.
In anatomical resection of the liver, transection of the hepatic vein or Glisson's pedicle is necessary. We examined the surgical records and outcome of 25 patients who underwent hepatectomy. An endovascular stapler with 35 and 60 mm staples was used for transection of the hepatic vein or Glisson's pedicle, and hepatic parenchyma including vessels. Surgery included also left lateral sectorectomy in 6 patients, right lateral sectorectomy in one, right hepatectomy in 12, left hepatectomy in two and trisegmentectomy in 4. Endovascular stapling was used for transection of hepatic veins (n=25) in all patients and Glisson's pedicle (n=8). No failure of firing occurred during cutting. Injury of an aberrant bile duct occurred in one patient, but none suffered bleeding or bile leakage from the transected parts. Vascular transection using vascular stapler could be performed safely and rapidly during anatomical hepatic resection.
Nanashima
Atsushi
A
Division of Surgical Oncology, Department of Translational Medical Sciences Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan. a-nanasm@net.nagasaki-u.ac.jp
Sumida
Yorihisa
Y
Oikawa
Masahiro
M
Murakami
Goshi
G
Abo
Takafumi
T
Hidaka
Shigekazu
S
Takeshita
Hiroaki
H
Sawai
Terumitsu
T
Nagayasu
Takeshi
T
D000368:Aged; D000369:Aged, 80 and over; D001661:Biliary Tract Neoplasms / Q000601:surgery*; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006503:Hepatic Veins / Q000601:surgery*; D006801:Humans; D008099:Liver / Q000098:blood supply; D008113:Liver Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D017792:Surgical Stapling; D016896:Treatment Outcome