May the method of hepatic parenchymal transection influence early results of liver surgery?

Hepatogastroenterology. 2010 Mar-Apr;57(98):321-5.

Abstract

Background/aims: Aim of this work was to analyze retrospectively two groups of patients who underwent hepatic resection using two different techniques, to determine whether exists a difference in hepatic tolerance and in the early outcome.

Methodology: We retrospectively analyzed seventy-one patients divided into group 1, treated with kellyclasia and Pringle maneuver, and group 2 treated with a radiofrequency device. The following parameters were analyzed: age; sex; type of disease, number of major/minor resections; total operative time and transection time; number and time of clampings; blood loss; pre- and postoperative transaminases and total bilirubin; length of hospitalization; morbidity and mortality.

Results: Median total operative time and median hospital stay were similar in both groups but median median blood loss was higher in group 1. ALT levels in group 1 were higher than in group 2. Morbidity and mortality were observed only in group 1.

Conclusions: Kelly-crush is related to a lower parenchymal tolerance as shown by the higher increase in postoperative alanine aminotransferase levels.

MeSH terms

  • Adult
  • Aged
  • Catheter Ablation / methods
  • Diagnostic Imaging
  • Female
  • Hepatectomy / methods*
  • Humans
  • Liver Diseases / diagnosis
  • Liver Diseases / surgery*
  • Male
  • Middle Aged
  • Retrospective Studies
  • Treatment Outcome