Jin Bin1, Zhou Binghai2, Hu Sanyuan3. 1. Department of General Surgery, Qilu Hospital of Shan Dong University, Jinan, 250012, China. jinbin9449@126.com. 2. Department of General Surgery, Qilu Hospital of Shan Dong University, Jinan, 250012, China. 3. Department of General Surgery, Qilu Hospital of Shan Dong University, Jinan, 250012, China. husanyuan1962@hotmail.com.
Abstract
BACKGROUND: Although laparoscopy is widely accepted for liver resection, lesions in the posterior and superior segments and deep region in the right lobe are difficult for visualization during laparoscopic liver resection (LLR). In this study, we aim examine the effects of using sterile gloves (SG) pouch padding during LLR. METHODS: Forty-two hepatocellular carcinoma (HCC) patients were included in our study. We performed LLR using SG (n = 24, SG group) and without SG during LLR (n = 18, NSG). We also compared the time of various procedures, blood loss, and liver function between the two groups. RESULTS: We did not observe any major complications or death in all patients. The time of liver parenchyma transection and portal triad clamping in SG group is significantly shorter than those in NSG group (30.29 ± 5.55 vs. 39.00 ± 3.68 min p < .001 for liver parenchyma transection, 23.00 ± 5.60 vs. 31.60 ± 5.03 min p < .001 for portal triad clamping). Blood loss in SG group (162.91 ± 90.91 ml) was significantly lower than in NSG group (236.66 ± 101.67 ml p = .024). The levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were increased one day after LLR, and decreased to normal level on day 7 after LLR in both groups. CONCLUSIONS: Our data suggests that a sterile glove pouch could enhance exposure in surgical field, which results in decrease in blood loss and procedure time. More studies with large sample size, large tumor size, and longer follow-up are needed.
BACKGROUND: Although laparoscopy is widely accepted for liver resection, lesions in the posterior and superior segments and deep region in the right lobe are difficult for visualization during laparoscopic liver resection (LLR). In this study, we aim examine the effects of using sterile gloves (SG) pouch padding during LLR. METHODS: Forty-two hepatocellular carcinoma (HCC) patients were included in our study. We performed LLR using SG (n = 24, SG group) and without SG during LLR (n = 18, NSG). We also compared the time of various procedures, blood loss, and liver function between the two groups. RESULTS: We did not observe any major complications or death in all patients. The time of liver parenchyma transection and portal triad clamping in SG group is significantly shorter than those in NSG group (30.29 ± 5.55 vs. 39.00 ± 3.68 min p < .001 for liver parenchyma transection, 23.00 ± 5.60 vs. 31.60 ± 5.03 min p < .001 for portal triad clamping). Blood loss in SG group (162.91 ± 90.91 ml) was significantly lower than in NSG group (236.66 ± 101.67 ml p = .024). The levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were increased one day after LLR, and decreased to normal level on day 7 after LLR in both groups. CONCLUSIONS: Our data suggests that a sterile glove pouch could enhance exposure in surgical field, which results in decrease in blood loss and procedure time. More studies with large sample size, large tumor size, and longer follow-up are needed.
Authors: Joseph F Buell; Daniel Cherqui; David A Geller; Nicholas O'Rourke; David Iannitti; Ibrahim Dagher; Alan J Koffron; Mark Thomas; Brice Gayet; Ho Seong Han; Go Wakabayashi; Giulio Belli; Hironori Kaneko; Chen-Guo Ker; Olivier Scatton; Alexis Laurent; Eddie K Abdalla; Prosanto Chaudhury; Erik Dutson; Clark Gamblin; Michael D'Angelica; David Nagorney; Giuliano Testa; Daniel Labow; Derrik Manas; Ronnie T Poon; Heidi Nelson; Robert Martin; Bryan Clary; Wright C Pinson; John Martinie; Jean-Nicolas Vauthey; Robert Goldstein; Sasan Roayaie; David Barlet; Joseph Espat; Michael Abecassis; Myrddin Rees; Yuman Fong; Kelly M McMasters; Christoph Broelsch; Ron Busuttil; Jacques Belghiti; Steven Strasberg; Ravi S Chari Journal: Ann Surg Date: 2009-11 Impact factor: 12.969
Authors: Steven C Katz; Jinru Shia; Kui Hin Liau; Mithat Gonen; Leyo Ruo; William R Jarnagin; Yuman Fong; Michael I D'Angelica; Leslie H Blumgart; Ronald P Dematteo Journal: Ann Surg Date: 2009-04 Impact factor: 12.969