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CURRENT ISSUEMINERVA CHIRURGICA

A Journal on Surgery


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Minerva Chirurgica 2016 Nov 04

Precise hepatectomy based on the optimized technique of hepatic blood flow occlusion combined with the curettage and cut technique by electrotome

Bin HUANG 1, Yu YU 1, Shaoyong ZHAO 1, Changsong WANG 1, Wenhao ZHOU 1, Huashan JIANG 2, Min CHEN 3, Xiaozhong JIANG 1, Youjiang TAO 1, Tao LV 1, Hong LUO 1, Xiao CUI 1, Yi ZHANG 1, Xiaoqin GUO 1

1 Department of Hepatopancreatobiliary Surgery, No. 2 People’s Hospital of Yibin, Yibin, Sichuan, China; 2 Department of General Surgery, Yibin County People’s Hospital, Yibin, Sichuan, China; 3 Department of Anesthesiology, No. 2 People’s Hospital of Yibin, Yibin, Sichuan, China

BACKGROUND: To evaluate the outcome of precise hepatectomy based on the optimized technique of hepatic blood flow occlusion combined with the curettage and cut technique by electrotome.
METHODS: Hospitalized patients with primary liver cancer treated in our hospital were included in this study and all patients (n=61) were numbered according to the inclusion sequence and were randomized into group A and group B: (1) group A: precise liver resection by using simplified blocking combining with electrotome; (2) group B: precise liver resection by using half-hepatic occlusion + CUSA assisting liver parenchyma transection+ lower central venous pressure controlled by the anesthesiologist. Postoperative laboratory examination data (blood routine, liver function, renal function, blood coagulation function, AFP quantitation) were collected, including WBC, alanine aminotransferase (ALT), total bilirubin (TBIL), prothrombin time (PT), creatinine (Cr), abdominal drainage volume, intra-abdominal hemorrhage, bile leakage, blood transfusion, time of postoperative passage of gas by anus, and length between postoperation and discharge.
RESULTS: Five days post-surgery, the value of WBC between groups A and B were not significant different (8.9±2.2 vs. 8.3±2.8, P>0.05) (Table 1). The ALT, PT, Cr, abdominal drainage volume, abdominal drainage volume, intra-abdominal hemorrhage, bile leakage, blood transfusion, and time of postoperative passage of gas by anus between group A and B were not significant different postoperatively, respectively. And also, the length between postoperation and discharge were not significant different between two groups.
CONCLUSIONS: Precise hepatectomy based on the optimized technique of hepatic blood flow occlusion combined with the curettage and cut technique by electrotome works well. This technology has a low requirement for hospital’s operation condition and anesthetist, so it carries out a new route for the wide application of precise liver resection in basal hospitals.

language: English


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