BACKGROUND: Parenchymal transection is the most important step of liver resection, and during this phase, blood loss may lead to morbidity and mortality. Liver parenchyma can be transected by different ways such as finger fracture, clamp crushing, or instrument-based techniques. METHODS: A simple and cost-efficient method has been developed for liver transection using a technique based on silk crushing of the liver substance. RESULTS: We have successfully employed this technique in 278 consecutive liver resections from July 2001 to March 2006. The average duration of hepatic transection varied according to the type of liver resection: 22 min (range 15-42), 19 min (range 11-37), and 12 min (range 7-21) for right hepatectomy, left hepatectomy, and bisegmentectomy 2-3, respectively. The mean transection speed was 6.9 +/- 2.3 cm(2)/min. Blood transfusions were necessary in 42 patients (15.1%), and there were three operative deaths (1.1%). Morbidity rate was 20.9% (58 patients). CONCLUSIONS: This technique allows a safe and quick liver transection without the use of expensive hemostatic devices, and also precludes the use of inflow occlusion maneuvers. We recommend the use of this technique in centers with low economic resources.
BACKGROUND: Parenchymal transection is the most important step of liver resection, and during this phase, blood loss may lead to morbidity and mortality. Liver parenchyma can be transected by different ways such as finger fracture, clamp crushing, or instrument-based techniques. METHODS: A simple and cost-efficient method has been developed for liver transection using a technique based on silk crushing of the liver substance. RESULTS: We have successfully employed this technique in 278 consecutive liver resections from July 2001 to March 2006. The average duration of hepatic transection varied according to the type of liver resection: 22 min (range 15-42), 19 min (range 11-37), and 12 min (range 7-21) for right hepatectomy, left hepatectomy, and bisegmentectomy 2-3, respectively. The mean transection speed was 6.9 +/- 2.3 cm(2)/min. Blood transfusions were necessary in 42 patients (15.1%), and there were three operative deaths (1.1%). Morbidity rate was 20.9% (58 patients). CONCLUSIONS: This technique allows a safe and quick liver transection without the use of expensive hemostatic devices, and also precludes the use of inflow occlusion maneuvers. We recommend the use of this technique in centers with low economic resources.
Authors: Andreas Jm Koszka; Fabio G Ferreira; Caio Gg de Aquino; Maurício A Ribeiro; André S Gallo; Elisa Mc Aranzana; Luiz A Szutan Journal: World J Hepatol Date: 2010-07-27
Authors: Enio Campos Amico; José Roberto Alves; Samir Assi João; Priscila Luana Franco Costa Guimarães; Joafran Alexandre Costa de Medeiros; Élio José Silveira da Silva Barreto Journal: Arq Bras Cir Dig Date: 2016 Jul-Sep