title: Randomized clinical trial of BiClamp forceps versus clamp-crushing technique in open liver resection.
abstract: BACKGROUND
  The aim of this trial was to compare the efficacy and safety of BiClamp forceps with the "gold-standard" clamp-crushing technique for open liver resection.
  
  
  METHODS
  From October 2014 to May 2016, 86 consecutive patients scheduled to undergo hepatic resection were randomized to a BiClamp forceps group (n = 43) or to a clamp-crushing technique group (n = 43).
  
  
  RESULTS
  Background characteristics of the two groups were closely matched. There were no significant differences between the BiClamp forceps group and clamp-crushing group in total intraoperative blood loss (339.81 ± 257.20 ml vs. 376.73 ± 303.67 ml, respectively; P = 0.545) or blood loss per transection area (5.35 ± 3.27 ml/cm2vs. 5.44 ± 3.02 ml/cm2, respectively; P = 0.609). Liver transection speed, the need of blood transfusion, morbidity, length of postoperative hospital stay, total hospitalization cost and liver function recovery were similar in the two groups. Multivariate logistic regression analysis identified major hepatectomy, multiple resections and liver transection time ≥30 min as significantly unfavorable factors for decreased intraoperative blood loss.
  
  
  CONCLUSIONS
  Liver parenchymal transection with BiClamp forceps is as safe and feasible as the gold-standard clamp-crushing technique.
authors.affiliation: Department of Surgery, Second Affiliated Hospital of Anhui Medical University, No. 678 Furong Road, Jingkai District, Hefei, Anhui 230022, China.
authors.forename: Jiang Ming
authors.initials: JM
authors.lastname: Chen
authors.affiliation: Department of Liver Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Geng
authors.affiliation: Department of Surgery, Second Affiliated Hospital of Anhui Medical University, No. 678 Furong Road, Jingkai District, Hefei, Anhui 230022, China.
authors.forename: Song
authors.initials: S
authors.lastname: Zhang
authors.affiliation: Department of Surgery, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
authors.forename: Fu Bao
authors.initials: FB
authors.lastname: Liu
authors.affiliation: Department of Surgery, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
authors.forename: Hong Chuan
authors.initials: HC
authors.lastname: Zhao
authors.affiliation: Department of Surgery, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
authors.forename: Yi Jun
authors.initials: YJ
authors.lastname: Zhao
authors.affiliation: Department of Surgery, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
authors.forename: Guo Bin
authors.initials: GB
authors.lastname: Wang
authors.affiliation: Department of Surgery, Second Affiliated Hospital of Anhui Medical University, No. 678 Furong Road, Jingkai District, Hefei, Anhui 230022, China.
authors.forename: Sheng Xue
authors.initials: SX
authors.lastname: Xie
authors.affiliation: Department of Surgery, Second Affiliated Hospital of Anhui Medical University, No. 678 Furong Road, Jingkai District, Hefei, Anhui 230022, China.
authors.forename: Xiao Ping
authors.initials: XP
authors.lastname: Geng
mesh_terms: D016063:Blood Loss, Surgical / Q000517:prevention & control; D005260:Female; D006498:Hepatectomy / Q000295:instrumentation*; D006801:Humans; D008107:Liver Diseases / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013525:Surgical Instruments; D016896:Treatment Outcome
keywords: Blood loss; Clamp-crushing technique; Liver resection