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Simplified Inflow Control Using Stapling Devices for Major Hepatic Resection

Simplified Inflow Control Using Stapling Devices for Major Hepatic Resection Abstract We describe the efficacy of a new technique for hepatic inflow division using stapling devices in major hepatic resections. We studied 28 consecutive patients who underwent major hepatic resection at a tertiary referral center by en masse inflow control of Glisson's pedicle in 1993 and 1994, of whom 10 underwent inflow control with stapling devices. Although stapling devices were used for larger tumors (mean±SD, 12.2±8.6 vs 5.7±5.0 cm; P=.02), the operation time (261±57 vs 301±143 minutes), operative blood loss (2071± 1318 vs 4792±6586 mL), postoperative intra-abdominal bleeding (0% [0/10] vs 17% [3/18]), and hospital stay (16.0±2.6 vs 20.6±7.4 days) were favorable for resections with staplers vs resections without staplers; the overall incidences of postoperative complications (40% [4/10] vs 39% [7/18]) and hospital death (10% [1/10] vs 6% [1/18]) were comparable in the two groups. We conclude that stapling devices allow simple, quick, and safe en masse inflow control in major hepatic resections. (Arch Surg. 1996;131:104-106) References 1. Ryan JA Jr, Faulkner DJ II. Liver resection without blood transfusion . Am J Surg . 1989;157: 472-475.Crossref 2. Takenaka K, Kanematsu T, Fukuzawa K, et al. Can hepatic failure after surgery for hepatocellular carcinoma in cirrhotic patients be prevented? World J Surg . 1990;14:123-127.Crossref 3. Okamoto E, Yamanaka N, Toyosaka A, et al. Current status of hepatic resection in the treatment of hepatocellular carcinoma . In: Okuda I, Ishak KG, eds. Neoplasms of the Liver . Tokyo, Japan: Springer Verlag; 1987:353-365. 4. Takasaki K, Kobayashi S, Tanaka S, et al. Highly anatomically systematized hepatic resection with Glissonean sheath code transection at the hepatic hilus . Int Surg . 1990;75:73-77. 5. Yanaga K, Matsumata T, Nishizaki T, et al. Alternate hemihepatic vascular control technique for hepatic resection . Am J Surg . 1993;165:365-366.Crossref 6. Starzl TE, Bell RH, Beart RW, et al. Hepatic trisegmentectomy and other liver resections . Surg Gynecol Obstet . 1975;141:429-437. 7. Schwartz SI. Right hepatic lobectomy . Am J Surg . 1984;148:668-673.Crossref 8. MacIntosh EL, Minuk GY. Hepatic resection in patients with cirrhosis and hepatocellular carcinoma . Surg Gynecol Obstet . 1992;174:245-254. 9. Kanematsu T, Takenaka K, Furuta T, et al. Acute portal hypertension associated with liver resection: analysis of early post-operative death . Arch Surg . 1985;120:1303-1305.Crossref 10. Voyles CR, Vogel SB. Hepatic resection using stapling devices to control the hepatic veins . Am J Surg . 1989;158:459-460.Crossref 11. McEntee GP. Nagorney DM. Use of vascular staplers in major hepatic resections . Br J Surg . 1991; 78:40-41.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Simplified Inflow Control Using Stapling Devices for Major Hepatic Resection

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Publisher
American Medical Association
Copyright
Copyright © 1996 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1996.01430130106025
Publisher site
See Article on Publisher Site

Abstract

Abstract We describe the efficacy of a new technique for hepatic inflow division using stapling devices in major hepatic resections. We studied 28 consecutive patients who underwent major hepatic resection at a tertiary referral center by en masse inflow control of Glisson's pedicle in 1993 and 1994, of whom 10 underwent inflow control with stapling devices. Although stapling devices were used for larger tumors (mean±SD, 12.2±8.6 vs 5.7±5.0 cm; P=.02), the operation time (261±57 vs 301±143 minutes), operative blood loss (2071± 1318 vs 4792±6586 mL), postoperative intra-abdominal bleeding (0% [0/10] vs 17% [3/18]), and hospital stay (16.0±2.6 vs 20.6±7.4 days) were favorable for resections with staplers vs resections without staplers; the overall incidences of postoperative complications (40% [4/10] vs 39% [7/18]) and hospital death (10% [1/10] vs 6% [1/18]) were comparable in the two groups. We conclude that stapling devices allow simple, quick, and safe en masse inflow control in major hepatic resections. (Arch Surg. 1996;131:104-106) References 1. Ryan JA Jr, Faulkner DJ II. Liver resection without blood transfusion . Am J Surg . 1989;157: 472-475.Crossref 2. Takenaka K, Kanematsu T, Fukuzawa K, et al. Can hepatic failure after surgery for hepatocellular carcinoma in cirrhotic patients be prevented? World J Surg . 1990;14:123-127.Crossref 3. Okamoto E, Yamanaka N, Toyosaka A, et al. Current status of hepatic resection in the treatment of hepatocellular carcinoma . In: Okuda I, Ishak KG, eds. Neoplasms of the Liver . Tokyo, Japan: Springer Verlag; 1987:353-365. 4. Takasaki K, Kobayashi S, Tanaka S, et al. Highly anatomically systematized hepatic resection with Glissonean sheath code transection at the hepatic hilus . Int Surg . 1990;75:73-77. 5. Yanaga K, Matsumata T, Nishizaki T, et al. Alternate hemihepatic vascular control technique for hepatic resection . Am J Surg . 1993;165:365-366.Crossref 6. Starzl TE, Bell RH, Beart RW, et al. Hepatic trisegmentectomy and other liver resections . Surg Gynecol Obstet . 1975;141:429-437. 7. Schwartz SI. Right hepatic lobectomy . Am J Surg . 1984;148:668-673.Crossref 8. MacIntosh EL, Minuk GY. Hepatic resection in patients with cirrhosis and hepatocellular carcinoma . Surg Gynecol Obstet . 1992;174:245-254. 9. Kanematsu T, Takenaka K, Furuta T, et al. Acute portal hypertension associated with liver resection: analysis of early post-operative death . Arch Surg . 1985;120:1303-1305.Crossref 10. Voyles CR, Vogel SB. Hepatic resection using stapling devices to control the hepatic veins . Am J Surg . 1989;158:459-460.Crossref 11. McEntee GP. Nagorney DM. Use of vascular staplers in major hepatic resections . Br J Surg . 1991; 78:40-41.Crossref

Journal

Archives of SurgeryAmerican Medical Association

Published: Jan 1, 1996

References