Usefulness of the combination procedure of crash clamping and vessel sealing for hepatic resection.
BACKGROUND
Minimization of blood loss during resection of the hepatic parenchyma in hepatectomy remains a major problem. The usefulness of the LigaSure sealing system has been reported.


OBJECTIVE
To evaluate the efficacy of combination procedure of LigaSure and forceps clamping for control blood loss and transection time in hepatectomy.


METHODS
Here, we report our experience with the combination technique of LigaSure Precise, a clamp forceps type, and crush clamping method for hepatic transection in 33 patients who underwent hepatectomy.


RESULTS
The combination technique allows fast and bloodless transection even along the major intrahepatic vessels. Blood loss and transection time were significantly reduced in the group of LigaSure use (P < 0.05). Efficient hemostasis could be achieved also in patients with extensive liver injury such as cirrhosis. The rates of postoperative intraabdominal abscess formation in the combination technique of LigaSure and crush clamping were lower compared with the conventional crush clamping method (P < 0.05).


CONCLUSIONS
The combined use of LigaSure Precise and crush clamping technique is safe and allows rapid completion of hepatic resection.
Nanashima
Atsushi
A
Division of Surgical Oncology, Department of Translational Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan. a-nanasm@nagasaki-u.ac.jp
Tobinaga
Syuuichi
S
Abo
Takafumi
T
Nonaka
Takashi
T
Sawai
Terumitsu
T
Nagayasu
Takeshi
T
D018784:Abdominal Abscess / Q000453:epidemiology; D000368:Aged; D016063:Blood Loss, Surgical / Q000517:prevention & control / Q000706:statistics & numerical data; D016022:Case-Control Studies; D004564:Electrocoagulation / Q000295:instrumentation*; D004867:Equipment Design; D017707:Erythrocyte Transfusion / Q000706:statistics & numerical data; D005260:Female; D006488:Hemostasis, Surgical / Q000295:instrumentation*; D006498:Hepatectomy / Q000295:instrumentation* / Q000379:methods*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D013997:Time Factors