Hepatic parenchymal transection with vascular staplers: a comparative analysis with the crush-clamp technique

Srinevas K. Reddy, Andrew S. Barbas, Tong J. Gan, Steven E. Hill, Anthony M. Roche, Bryan M. Clary

Research output: Contribution to journalArticle

9 Scopus citations

Abstract

Background: This retrospective study compares the safety and efficacy of hepatic parenchymal transection using vascular staplers (VS) and the crush-clamp (CC) technique. Methods: Demographics, clinicopathologic data, treatments, and postoperative outcomes from patients who underwent VS or CC hepatic parenchymal transection were compared. Results: From 1996-2006, 99 and 112 patients underwent hepatic transection with VS and CC, respectively. Compared to CC, VS transection was associated with less operative time (median 210 vs 275 minutes), blood loss (median 250 vs 500 mL), and postoperative red blood cell (RBC) transfusion (29% vs 44%), all P < .05. VS transection was not associated with RBC transfusion on multivariate analysis. There were no differences in rates of positive resection margins (9% vs 13%), postoperative mortality (2% vs 4%), overall morbidity (32% vs 29%), and severe morbidity (20% vs. 23%), all P > .05. Conclusion: Hepatic parenchymal transection with VS can be accomplished with similar safety and efficacy as CC transection.

Original languageEnglish (US)
Pages (from-to)760-767
Number of pages8
JournalAmerican journal of surgery
Volume196
Issue number5
DOIs
StatePublished - Nov 1 2008

Keywords

  • Crush-clamp
  • Hepatic transection
  • Morbidity
  • Mortality
  • Vascular stapler

ASJC Scopus subject areas

  • Surgery

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