Hepatic parenchymal transection with vascular staplers: a comparative analysis with the crush-clamp technique

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• 作者：Srinevas K. Reddy ; Andrew S. Barbas ; Tong J. Gan ; Steven E. Hill ; Anthony M. Roche ; Bryan M. Clary
• 关键词：Vascular stapler ; Hepatic transection ; Crush-cl Morbidity ; Mortality
• 刊名：The American Journal of Surgery
• 出版年：2008
• 出版时间：November 2008
• 年：2008
• 卷：196
• 期：5
• 页码：760-767
• 全文大小：109 K

文摘

Background

This retrospective study compares the safety and efficacy of hepatic parenchymal transection using vascular staplers (VS) and the crush-clamp (CC) technique.

Methods

Demographics, clinicopathologic data, treatments, and postoperative outcomes from patients who underwent VS or CC hepatic parenchymal transection were compared.

Results

From 1996–2006, 99 and 112 patients underwent hepatic transection with VS and CC, respectively. Compared to CC, VS transection was associated with less operative time (median 210 vs 275 minutes), blood loss (median 250 vs 500 mL), and postoperative red blood cell (RBC) transfusion (29 % vs 44 % ), all P < .05. VS transection was not associated with RBC transfusion on multivariate analysis. There were no differences in rates of positive resection margins (9 % vs 13 % ), postoperative mortality (2 % vs 4 % ), overall morbidity (32 % vs 29 % ), and severe morbidity (20 % vs. 23 % ), all P > .05.

Conclusion

Hepatic parenchymal transection with VS can be accomplished with similar safety and efficacy as CC transection.