超声刀行肝实质离断对术后出血和胆漏的影响

Impact of Ultrasonic Scalpels for Liver Parenchymal Transection on Postoperative Bleeding and Bile Leakage.

作者信息

Kostakis Ioannis D, Machairas Nikolaos, Garoufalia Zoe, Prodromidou Anastasia, Sotiropoulos Georgios C

机构信息

Second Department of Propaedeutic Surgery, "Laiko" General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece

Second Department of Propaedeutic Surgery, "Laiko" General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.

出版信息

In Vivo. 2018 Jul-Aug;32(4):883-886. doi: 10.21873/invivo.11323.

DOI:10.21873/invivo.11323

PMID:29936474

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6117760/

Abstract

BACKGROUND/AIM: Novel techniques for liver parenchymal transection have emerged and they are available to the hepatobiliary surgeon. The aim of our study was to compare two types of ultrasonic scalpels (Lotus and Harmonic) and examine how they perform either alone or in combination with the SonaStar ultrasonic surgical aspiration system regarding postoperative bleeding and bile leakage.

PATIENTS AND METHODS

Our prospectively maintained database of patients who underwent liver resections in our Department was reviewed. One hundred and two patients with solid liver lesions underwent liver resection by a senior hepatobiliary surgeon in our department during a period of 51 months. They were divided into four groups according to the devices that were used for liver parenchymal transection.

RESULTS

Patients were divided into the following groups: group 1: Lotus, 32 patients (31.4%); group 2: Lotus+SonaStar, 27 patients (26.5%); group 3: Harmonic, 27 patients (26.5%); group 4: Harmonic+SonaStar, 16 patients (15.7%). There were 5 cases of postoperative bleeding and 9 cases of postoperative bile leakage. No significant difference was found concerning postoperative bleeding (group 1: 2/32; 6.3%, group 2: 2/27; 7.4%, group 3: 0/27; 0%, group 4: 1/16; 6.3%) (p=0.577). Furthermore, no actual difference was detected in terms of postoperative bile leakage (group 1: 2/32; 6.3%, group 2: 3/27; 11.1%, group 3: 3/27; 11.1%, group 4: 1/16; 6.3%) (p=0.866).

CONCLUSION

Both Lotus and Harmonic ultrasonic scalpels provide adequate and similar results concerning postoperative hemorrhage and cholorrhea.

摘要

背景/目的：肝脏实质离断的新技术不断涌现，可供肝胆外科医生使用。本研究旨在比较两种超声刀（莲花刀和超声刀），并研究它们单独使用或与索纳星超声手术吸引系统联合使用时在术后出血和胆漏方面的表现。

患者与方法

回顾了我们科室前瞻性维护的接受肝切除术患者的数据库。在51个月期间，102例患有肝脏实性病变的患者由我们科室的一位资深肝胆外科医生进行了肝切除术。根据用于肝脏实质离断的设备，将他们分为四组。

结果

患者分为以下几组：第1组：莲花刀组，32例患者（31.4%）；第2组：莲花刀+索纳星组，27例患者（26.5%）；第3组：超声刀组，27例患者（26.5%）；第4组：超声刀+索纳星组，16例患者（15.7%）。术后有5例出血和9例胆漏。术后出血方面未发现显著差异（第1组：2/32；6.3%，第2组：2/27；7.4%，第3组：0/27；0%，第4组：1/16；6.3%）（p=0.577）。此外，术后胆漏方面也未发现实际差异（第1组：2/32；6.3%，第2组：3/27；11.1%，第3组：3/27；11.1%，第4组：1/16；6.3%）（p=0.866）。