Tissue preserving hepatectomy by a vessel sealing device.

BACKGROUND

The intraoperative blood loss and the biliary leak constitute the major causes of postoperative morbidity following liver resection. We describe a new technique for liver parenchyma transection using the Atlas modification of the ligasure vessel sealing system. The gradual closure of the instrument may cause crushing of the hepatic tissue and heat sealing of the vessels and bile ducts at the same time.

MATERIALS AND METHODS

Ten cirrhotic patients (group A) underwent minor liver resections due to hepatocellular carcinoma (HCC). In four of these patients a bisegmentectomy was carried out, whereas in the remaining six the resection involved one segment. In addition, twelve patients with localized metastatic liver disease (group B) underwent tissue preserving hepatectomy also. Six of these patients underwent a bisegmentectomy and six had a local resection involving one segment.

RESULTS

The blood loss in the first group varied from 120 to 350 ml, whereas in the second group varied from 80 to 280 ml. No postoperative biliary leakage was mentioned.

CONCLUSION

This alternative technique of dividing the hepatic parenchyma seems to be simple and efficacious in preventing significant blood loss and bile leak in minor liver resections.