Vascular transection using endovascular stapling in hepatic resection.

In anatomical resection of the liver, transection of the hepatic vein or Glisson's pedicle is necessary. We examined the surgical records and outcome of 25 patients who underwent hepatectomy. An endovascular stapler with 35 and 60 mm staples was used for transection of the hepatic vein or Glisson's pedicle, and hepatic parenchyma including vessels. Surgery included also left lateral sectorectomy in 6 patients, right lateral sectorectomy in one, right hepatectomy in 12, left hepatectomy in two and trisegmentectomy in 4. Endovascular stapling was used for transection of hepatic veins (n=25) in all patients and Glisson's pedicle (n=8). No failure of firing occurred during cutting. Injury of an aberrant bile duct occurred in one patient, but none suffered bleeding or bile leakage from the transected parts. Vascular transection using vascular stapler could be performed safely and rapidly during anatomical hepatic resection.