Combined ultrasonic aspiration and saline-linked radiofrequency precoagulation: a step toward bloodless liver resection without the need of liver inflow occlusion: analysis of 313 consecutive patients

World Journal of Surgical Oncology

Research

Jessamy Bagenal¹  Satvinder Mudan²  Ferdinando Cananzi²  Kyriakos Neofytou²  Evangelos Felekouras³  Emmanouel Pikoulis³  Athanasios Petrou⁴  Alexandros Giakoustidis⁵ 

[1] Bristol Heart Institute, Severn School of Surgery, Bristol, UK;Department of Academic Surgery, Upper GI/HPB Unit, Royal Marsden Hospital, Fulham Road, SW3 6JJ, London, UK;First Department of Surgery, University of Athens Medical School, Laikon Teaching Hospital, Αγ. Θωμά 17, Goudi, Athens, Greece;Nicosia Surgical Department, Division of Hepatobiliary Pancreatic Surgery, Nicosia General Hospital, Palaios Dromos Lefkosias - Lemesou, 215, 2029, Strovolos, Nicosia, Cyprus;The London Clinic, 20 Devonshire Pl, W1G 6BW, London, UK;

关键词: Liver resection;    Blood loss;    Pringle;    Complications;    Ultrasonic aspiration;    Radiofrequency;   

DOI  :  10.1186/1477-7819-12-357

 received in 2014-04-06, accepted in 2014-10-29,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundHemorrhage is undoubtedly one of the main factors contributing to morbidity and mortality in liver resections. Vascular occlusion techniques are effective in controlling intraoperative bleeding, but they cause liver damage due to ischemia. We evaluated the effectiveness and safety of using a combined technique for hepatic parenchymal transection without liver inflow occlusion.MethodsThree hundred and thirteen consecutive patients who underwent liver resection in four hepato-pancreato-biliary units. Hepatic parenchymal transection was carried out using a combined technique of saline-linked radiofrequency precoagulation and ultrasonic aspiration without liver inflow occlusion.ResultsDuring the study period 114 minor and 199 major hepatic resections were performed. The mean amount of intraoperative blood loss was 377 ml (SD 335 ml, range 50 to 2,400 ml) and the blood transfusion rate was 10.5%. The median amount of blood loss during parenchymal transection and parenchymal transection time was 222 ml (SD 224 ml, range 40 to 2,100 ml) and 61 minutes (range 12 to 150 minutes) respectively. There were two postoperative deaths (0.6%). Complications occurred in 84 patients (26.8%) and most complications were minor.ConclusionsCombined technique of saline-linked radiofrequency ablation and ultrasonic aspiration for liver resection is a safe method for both major and minor liver resections. The method is associated with decreased blood loss, reduced postoperative morbidity, and minimal mortality rates. We believe that this combined technique is comparable to other techniques and should be considered as an alternative.

【 授权许可】

Unknown   
© Felekouras et al.; licensee BioMed Central Ltd. 2014. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.