title: [Liver transection: modern procedure: Technique, results and costs].
abstract: Liver resection has developed into the current standard procedure due to modern resection techniques, profound knowledge of the liver anatomy and optimized surgical and anesthesiological strategies to allow extended resections with both low morbidity and mortality. Initially major blood loss was the biggest concern with liver resection and a Pringle's manoeuvre was necessary. Nowadays, biliary leakage is the major problem after liver surgery. Besides the classical conventional clamp crushing technique for parenchymal transection, various devices including ultrasound, microwaves and staplers have been introduced. Minimally invasive techniques have become increasingly important for liver resection but are still applied in selected patients only. The selection of the resection technique and device mainly depends on the extent of the resection and also on the liver parenchyma, the liver disease, costs, personal experiences and preferences. This article presents a selection of techniques used in modern parenchymal transection during liver resection with special focus on transection time, blood loss, bile leakage and costs.
authors.affiliation: Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Ruprecht-Karls-Universität, Im Neuenheimer Feld 110, 69120, Heidelberg, Deutschland.
authors.forename: H
authors.initials: H
authors.lastname: Bruns
authors.forename: M W
authors.initials: MW
authors.lastname: Büchler
authors.forename: P
authors.initials: P
authors.lastname: Schemmer
mesh_terms: D001658:Biliary Fistula / Q000209:etiology / Q000517:prevention & control* / Q000628:therapy; D003131:Combined Modality Therapy; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008107:Liver Diseases / Q000601:surgery*; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control* / Q000628:therapy; D019106:Postoperative Hemorrhage / Q000209:etiology / Q000517:prevention & control* / Q000628:therapy; D012086:Reoperation