» Articles » PMID: 29936474

Impact of Ultrasonic Scalpels for Liver Parenchymal Transection on Postoperative Bleeding and Bile Leakage

Overview
Journal In Vivo
Specialty Oncology
Date 2018 Jun 25
PMID 29936474
Citations 1
Authors
Affiliations
Soon will be listed here.
Abstract

Background/aim: Novel techniques for liver parenchymal transection have emerged and they are available to the hepatobiliary surgeon. The aim of our study was to compare two types of ultrasonic scalpels (Lotus and Harmonic) and examine how they perform either alone or in combination with the SonaStar ultrasonic surgical aspiration system regarding postoperative bleeding and bile leakage.

Patients And Methods: Our prospectively maintained database of patients who underwent liver resections in our Department was reviewed. One hundred and two patients with solid liver lesions underwent liver resection by a senior hepatobiliary surgeon in our department during a period of 51 months. They were divided into four groups according to the devices that were used for liver parenchymal transection.

Results: Patients were divided into the following groups: group 1: Lotus, 32 patients (31.4%); group 2: Lotus+SonaStar, 27 patients (26.5%); group 3: Harmonic, 27 patients (26.5%); group 4: Harmonic+SonaStar, 16 patients (15.7%). There were 5 cases of postoperative bleeding and 9 cases of postoperative bile leakage. No significant difference was found concerning postoperative bleeding (group 1: 2/32; 6.3%, group 2: 2/27; 7.4%, group 3: 0/27; 0%, group 4: 1/16; 6.3%) (p=0.577). Furthermore, no actual difference was detected in terms of postoperative bile leakage (group 1: 2/32; 6.3%, group 2: 3/27; 11.1%, group 3: 3/27; 11.1%, group 4: 1/16; 6.3%) (p=0.866).

Conclusion: Both Lotus and Harmonic ultrasonic scalpels provide adequate and similar results concerning postoperative hemorrhage and cholorrhea.

Citing Articles

A pilot study of virtual liver segment projection technology in subsegment-oriented laparoscopic anatomical liver resection when indocyanine green staining fails (with video).

Zeng X, Deng H, Dong Y, Hu H, Fang C, Xiang N Surg Endosc. 2024; 38(7):4057-4066.

PMID: 38806957 DOI: 10.1007/s00464-024-10912-w.

References
1.
Gurusamy K, Pamecha V, Sharma D, Davidson B . Techniques for liver parenchymal transection in liver resection. Cochrane Database Syst Rev. 2009; (1):CD006880. PMC: 11627300. DOI: 10.1002/14651858.CD006880.pub2. View

2.
Aragon R, Solomon N . Techniques of hepatic resection. J Gastrointest Oncol. 2012; 3(1):28-40. PMC: 3397635. DOI: 10.3978/j.issn.2078-6891.2012.006. View

3.
Appere F, Piardi T, Memeo R, Lardiere-Deguelte S, Chetboun M, Sommacale D . Comparative Study With Propensity Score Matching Analysis of Two Different Methods of Transection During Hemi-Right Hepatectomy: Ultracision Harmonic Scalpel Versus Cavitron Ultrasonic Surgical Aspirator. Surg Innov. 2017; 24(5):499-508. DOI: 10.1177/1553350617723269. View

4.
Alexiou V, Tsitsias T, Mavros M, Robertson G, Pawlik T . Technology-assisted versus clamp-crush liver resection: a systematic review and meta-analysis. Surg Innov. 2012; 20(4):414-28. DOI: 10.1177/1553350612468510. View

5.
Mbah N, Brown R, Bower M, Scoggins C, McMasters K, Martin R . Differences between bipolar compression and ultrasonic devices for parenchymal transection during laparoscopic liver resection. HPB (Oxford). 2012; 14(2):126-31. PMC: 3277055. DOI: 10.1111/j.1477-2574.2011.00414.x. View