TY - JOUR
T1 - Experience with a simple clamp-crush technique devoid of other devices for liver resections in a surgical oncology practice
AU - Schwarz, Roderich E.
N1 - Publisher Copyright:
© 2015 Elsevier Inc. All rights reserved.
PY - 2015/3/1
Y1 - 2015/3/1
N2 - Background Parenchyma transection techniques during liver resection (LR) are linked to intraoperative blood loss and postoperative morbidity, with a recent increased use of energy devices over traditional clamp-crush hepatotomy (CCH). Methods Prospectively collected data from 191 consecutive patients undergoing LR with exclusive CCH by a single surgeon were examined. Results There were 94 men and 97 women, with 25% primary and 59% secondary malignancies or other conditions (16%). Forty-nine percent of LRs were major, 65% anatomic, and 32% included extrahepatic components. Median Pringle time was 23 minutes (9 to 76), blood loss 300 mL (20 to 5,000), and red blood cell transfusion rate 14%. Morbidity rate was 27% with 6 deaths. Significant relationships were observed for blood loss with complex resections, transfusions, major morbidity, and length of stay, but not between Pringle time and any outcomes. Conclusion A CCH technique as employed in this LR experience without any use of additional devices can yield good postoperative results.
AB - Background Parenchyma transection techniques during liver resection (LR) are linked to intraoperative blood loss and postoperative morbidity, with a recent increased use of energy devices over traditional clamp-crush hepatotomy (CCH). Methods Prospectively collected data from 191 consecutive patients undergoing LR with exclusive CCH by a single surgeon were examined. Results There were 94 men and 97 women, with 25% primary and 59% secondary malignancies or other conditions (16%). Forty-nine percent of LRs were major, 65% anatomic, and 32% included extrahepatic components. Median Pringle time was 23 minutes (9 to 76), blood loss 300 mL (20 to 5,000), and red blood cell transfusion rate 14%. Morbidity rate was 27% with 6 deaths. Significant relationships were observed for blood loss with complex resections, transfusions, major morbidity, and length of stay, but not between Pringle time and any outcomes. Conclusion A CCH technique as employed in this LR experience without any use of additional devices can yield good postoperative results.
KW - Blood loss
KW - Clamp-crush hepatotomy
KW - Liver resection
KW - Parenchymal transection technique
KW - Pringle inflow occlusion
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U2 - 10.1016/j.amjsurg.2014.09.025
DO - 10.1016/j.amjsurg.2014.09.025
M3 - Article
C2 - 25557971
AN - SCOPUS:84925013023
SN - 0002-9610
VL - 209
SP - 503
EP - 508
JO - American Journal of Surgery
JF - American Journal of Surgery
IS - 3
ER -