title: Usefulness of the combination procedure of crash clamping and vessel sealing for hepatic resection.
abstract: 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.
authors.affiliation: Division of Surgical Oncology, Department of Translational Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan. a-nanasm@nagasaki-u.ac.jp
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nanashima
authors.forename: Syuuichi
authors.initials: S
authors.lastname: Tobinaga
authors.forename: Takafumi
authors.initials: T
authors.lastname: Abo
authors.forename: Takashi
authors.initials: T
authors.lastname: Nonaka
authors.forename: Terumitsu
authors.initials: T
authors.lastname: Sawai
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nagayasu
mesh_terms: 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