title: Experience with a simple clamp-crush technique devoid of other devices for liver resections in a surgical oncology practice.
abstract: BACKGROUND
  Parenchyma transection techniques during liver resection (LR) are linked to intraoperative blood loss and postoperative morbidity, with a recent increased use of energy devices over traditional clamp-crush hepatotomy (CCH).
  
  
  METHODS
  Prospectively collected data from 191 consecutive patients undergoing LR with exclusive CCH by a single surgeon were examined.
  
  
  RESULTS
  There were 94 men and 97 women, with 25% primary and 59% secondary malignancies or other conditions (16%). Forty-nine percent of LRs were major, 65% anatomic, and 32% included extrahepatic components. Median Pringle time was 23 minutes (9 to 76), blood loss 300 mL (20 to 5,000), and red blood cell transfusion rate 14%. Morbidity rate was 27% with 6 deaths. Significant relationships were observed for blood loss with complex resections, transfusions, major morbidity, and length of stay, but not between Pringle time and any outcomes.
  
  
  CONCLUSIONS
  A CCH technique as employed in this LR experience without any use of additional devices can yield good postoperative results.
authors.affiliation: Department of Surgery, Indiana University School of Medicine, South Bend, IU Health Goshen Center for Cancer Care, 200 High Park Avenue, Goshen, IN 46526, USA. Electronic address: RSchwarz@iuhealth.org.
authors.forename: Roderich E
authors.initials: RE
authors.lastname: Schwarz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical / Q000517:prevention & control* / Q000706:statistics & numerical data; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000295:instrumentation*; D006801:Humans; D008113:Liver Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009017:Morbidity / Q000639:trends; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control*; D011446:Prospective Studies; D015996:Survival Rate / Q000639:trends; D013536:Suture Techniques / Q000295:instrumentation*; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology
keywords: Blood loss; Clamp-crush hepatotomy; Liver resection; Parenchymal transection technique; Pringle inflow occlusion