Lamattina J C, Hosseini M, Fayek S A, Philosophe B, Barth R N
Division of Transplantation, University of Maryland School of Medicine, Baltimore, Maryland 21201, USA.
Transplant Proc. 2013 Jun;45(5):1931-3. doi: 10.1016/j.transproceed.2012.11.022.
Although the LigaSure device is widely used, its use in liver transplantation, where compounding factors of portal hypertension, coagulopathy, and thrombocytopenia exist, is poorly described.
From October 1, 2011, to December 31, 2011, 6 patients underwent liver transplantation with recipient hepatectomy utilizing the LigaSure device. Outcomes using the device were compared with 6 contemporaneous patients in whom the device was not used.
Patient demographics, preoperative laboratory values, and Model for End-Stage Liver Disease scores were not different. Recipient hepatectomy was performed, on average, 43 minutes faster using the LigaSure device (P = .02). Although total operative time and intraoperative blood product usage were lower when the LigaSure was used, these differences did not attain statistical significance. Duration of stay and recipient readmission rates were similar.
LigaSure vessel sealing is an efficient method for recipient hepatectomy in liver transplantation. Vessel sealing of caval, portal, and other structures can be safely performed in the setting of end-stage liver disease.
尽管LigaSure设备被广泛使用,但在存在门静脉高压、凝血病和血小板减少等复合因素的肝移植中的应用描述较少。
2011年10月1日至2011年12月31日,6例患者在接受肝移植时使用LigaSure设备进行受体肝切除术。将使用该设备的结果与同期未使用该设备的6例患者进行比较。
患者人口统计学、术前实验室值和终末期肝病模型评分无差异。使用LigaSure设备进行受体肝切除术的平均速度快43分钟(P = .02)。虽然使用LigaSure时总手术时间和术中血液制品使用量较低,但这些差异无统计学意义。住院时间和受体再入院率相似。
LigaSure血管封闭术是肝移植中受体肝切除术的一种有效方法。在终末期肝病情况下,可以安全地进行腔静脉、门静脉和其他结构的血管封闭。