title: BiClamp-Fracture Method in Pure Laparoscopic Hepatectomy: Verifying its Efficacy Irrespective of Liver Stiffness.
abstract: BACKGROUND
  Transecting cirrhotic liver in pure laparoscopic hepatectomy (PLH) is generally considered technically demanding. We have preferentially used BiClamp in PLH by fracturing liver parenchyma using this device. The aim of the current study was to retrospectively verify the efficacy of BiClamp-fracture method in transecting cirrhotic parenchyma.
  
  
  METHODS
  The medical records of 21 patients who underwent PLH using BiClamp-fracture method between April 2011 and September 2014 were examined. The patients were divided into the Nonstiff group (F0-F2, n=11) and the Stiff group (F3 and F4, n=10) and various surgical factors were compared between the groups.
  
  
  RESULTS
  The mean operation time, the mean intraoperative blood loss, and the mean postoperative hospital stay in the Stiff group were comparable with those in the Nonstiff group. There were no postoperative complications in both groups.
  
  
  CONCLUSIONS
  BiClamp-fracture method was effective in transecting liver parenchyma irrespective of liver stiffness in PLH.
authors.affiliation: *Department of Hepato-Biliary Pancreatic Surgery, Fukuoka City Hospital †Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Uchiyama
authors.forename: Kazutoyo
authors.initials: K
authors.lastname: Morita
authors.forename: Shinji
authors.initials: S
authors.lastname: Itoh
authors.forename: Kenji
authors.initials: K
authors.lastname: Takenaka
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Maehara
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000503:physiopathology / Q000601:surgery*; D004548:Elasticity; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000295:instrumentation*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008099:Liver / Q000503:physiopathology*; D008113:Liver Neoplasms / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D012189:Retrospective Studies; D013525:Surgical Instruments; D016896:Treatment Outcome