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肝切除术中阻断夹闭与血管封闭联合操作的效用

Usefulness of the combination procedure of crash clamping and vessel sealing for hepatic resection.

作者信息

Nanashima Atsushi, Tobinaga Syuuichi, Abo Takafumi, Nonaka Takashi, Sawai Terumitsu, Nagayasu Takeshi

机构信息

Division of Surgical Oncology, Department of Translational Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.

出版信息

J Surg Oncol. 2010 Aug 1;102(2):179-83. doi: 10.1002/jso.21575.

Abstract

BACKGROUND

Minimization of blood loss during resection of the hepatic parenchyma in hepatectomy remains a major problem. The usefulness of the LigaSure sealing system has been reported.

OBJECTIVES

To evaluate the efficacy of combination procedure of LigaSure and forceps clamping for control blood loss and transection time in hepatectomy.

METHODS

Here, we report our experience with the combination technique of LigaSure Precise, a clamp forceps type, and crush clamping method for hepatic transection in 33 patients who underwent hepatectomy.

RESULTS

The combination technique allows fast and bloodless transection even along the major intrahepatic vessels. Blood loss and transection time were significantly reduced in the group of LigaSure use (P < 0.05). Efficient hemostasis could be achieved also in patients with extensive liver injury such as cirrhosis. The rates of postoperative intraabdominal abscess formation in the combination technique of LigaSure and crush clamping were lower compared with the conventional crush clamping method (P < 0.05).

CONCLUSIONS

The combined use of LigaSure Precise and crush clamping technique is safe and allows rapid completion of hepatic resection.

摘要

背景

肝切除术中肝实质切除时减少失血仍然是一个主要问题。已报道了LigaSure封闭系统的有效性。

目的

评估LigaSure与钳夹联合操作在肝切除术中控制失血及缩短肝门阻断时间方面的疗效。

方法

在此,我们报告了33例行肝切除术患者采用LigaSure Precise(一种钳夹式)与压榨钳夹法联合技术进行肝实质离断的经验。

结果

该联合技术即使沿着肝内主要血管也能实现快速且无血的离断。使用LigaSure的组中失血量和离断时间显著减少(P < 0.05)。对于肝硬化等肝损伤广泛的患者也能实现有效的止血。与传统压榨钳夹法相比,LigaSure与压榨钳夹联合技术的术后腹腔内脓肿形成率更低(P < 0.05)。

结论

LigaSure Precise与压榨钳夹技术联合使用是安全的,且能快速完成肝切除。

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