Tan Jeremy, Hunt Andrew, Wijesuriya Ruwan, Delriviere Luc, Mitchell Andrew
Transplant and Hepatobiliary Unit, Department of General Surgery, Sir Charles Gairdner Hospital, Nedlands, Perth, Western Australia.
ANZ J Surg. 2010 Mar;80(3):182-5. doi: 10.1111/j.1445-2197.2009.05091.x.
Liver parenchymal transection can be associated with significant blood loss and morbidity. We present our initial experience with the Gyrus PlasmaKinetic coagulation device in liver parenchymal resection in both cirrhotic and non-cirrhotic patients.
Liver resections were performed in 51 consecutive patients, from 20 July 2005 to 31 August 2007, using the Gyrus PlasmaKinetic coagulator. Requirement for blood transfusions, operating time, duration of hospital stay and major complications were evaluated initially for the group as a whole. Subsequently, the 11 patients with histologically confirmed cirrhosis (nine men, two women, median age 54 years, range 24-74 years) were compared with 40 patients without cirrhosis (25 men, 15 women, median age 57 years, range 24-87 years).
There were 34 men and 17 women. The median age was 56 (range 24-87 years). There were 48 open procedures and 3 laparoscopic procedures. There were 30 major resections (>2 segments) and 21 minor resections (one to two segments). The overall median operating time was 260 min (range 90-690). Length of stay had a median of 9 days, range 4-50 days. Twenty-one patients (41%) required a blood transfusion. Two biliary leaks were observed in non-cirrhotic patients initially before the settings of the Gyrus device were optimized.
The Gyrus PlasmaKinetic coagulation device is a novel instrument for hepatic parenchymal transection in liver resection, which can be safely used in cirrhotic and non-cirrhotic patients.
肝实质离断可能导致大量失血及并发症。我们介绍了在肝硬化和非肝硬化患者肝实质切除术中使用Gyrus等离子体动力凝血设备的初步经验。
2005年7月20日至2007年8月31日，连续51例患者使用Gyrus等离子体动力凝血器进行肝切除术。首先对整个组评估输血需求、手术时间、住院时间及主要并发症。随后，将11例经组织学证实为肝硬化的患者（9例男性，2例女性，中位年龄54岁，范围24 - 74岁）与40例无肝硬化的患者（25例男性，15例女性，中位年龄57岁，范围24 - 87岁）进行比较。
患者中男性34例，女性17例。中位年龄为56岁（范围24 - 87岁）。有48例开放手术和3例腹腔镜手术。有30例大的肝切除术（>2个肝段）和21例小的肝切除术（1 - 2个肝段）。总体中位手术时间为260分钟（范围90 - 690分钟）。住院时间中位数为9天，范围4 - 50天。21例患者（41%）需要输血。在优化Gyrus设备设置之前，非肝硬化患者中最初观察到2例胆漏。
Gyrus等离子体动力凝血设备是肝切除术中用于肝实质离断的一种新型器械，可安全用于肝硬化和非肝硬化患者。
