Experience with a simple clamp-crush technique devoid of other devices for liver resections in a surgical oncology practice

Roderich E. Schwarz

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)503-508
Number of pages6
JournalAmerican journal of surgery
Volume209
Issue number3
DOIs
StatePublished - Mar 1 2015

Keywords

  • Blood loss
  • Clamp-crush hepatotomy
  • Liver resection
  • Parenchymal transection technique
  • Pringle inflow occlusion

ASJC Scopus subject areas

  • Surgery

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