Retrospective Study
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World J Gastroenterol. Jul 14, 2014; 20(26): 8638-8645
Published online Jul 14, 2014. doi: 10.3748/wjg.v20.i26.8638
Outcomes of simple saline-coupled bipolar electrocautery for hepatic resection
Jian-Yang Guo, De-Wei Li, Rui Liao, Ping Huang, Xian-Bing Kong, Ji-Ming Wang, Hong-Lin Wang, Shi-Qiao Luo, Xiong Yan, Cheng-You Du
Jian-Yang Guo, De-Wei Li, Rui Liao, Ping Huang, Xian-Bing Kong, Ji-Ming Wang, Hong-Lin Wang, Shi-Qiao Luo, Xiong Yan, Cheng-You Du, Department of Hepatobiliary Surgery, The First Affiliated Hospital, Chongqing Medical University, Chongqing 400016, China
Author contributions: Guo JY and Du CY designed the research; Guo JY, Liao R, Luo SQ and Yan X performed the research; Wang JM, Wang HL and Du CY contributed new reagents and analytic tools; Li DW, Liao R, Huang P and Kong XB analyzed the data; Guo JY, Li DW and Du CY wrote the paper.
Correspondence to: Cheng-You Du, MD, PhD, Department of Hepatobiliary Surgery, The First Affiliated Hospital, Chongqing Medical University, Yixueyuan Rd 1, Chongqing 400016, China. duchengyou@126.com
Telephone: +86-23-89011191 Fax: +86-23-68811487
Received: January 9, 2014
Revised: February 14, 2014
Accepted: April 2, 2014
Published online: July 14, 2014
Processing time: 185 Days and 19.7 Hours
Abstract

AIM: To evaluate the application of bipolar coagulation (BIP) in hepatectomy by comparing the efficacy of BIP alone, cavitron ultrasonic surgical aspirator (CUSA) + BIP and conventional clamp crushing (CLAMP).

METHODS: Based on our database of patient records, a total of 380 consecutive patients who underwent hepatectomy at our hospital were retrospectively studied for the efficacy of BIP alone, CUSA + BIP and CLAMP. Of all the patients, 75 received saline-coupled BIP (Group A), 53 received CUSA + BIP (Group B), and 252 received CLAMP (Group C). The pre-, mid-, and postoperative clinical manifestations were compared, and the effects of those maneuvers were evaluated.

RESULTS: There was no obvious difference among the preoperative indexes between the different groups. The operative time was longer in Groups A and B than in Group C (P < 0.001 for both). The amount of bleeding and the rate of transfusion during the operation were significantly higher in Group C than in Groups A and B (P < 0.001 for all). The incidence of postoperative complications in Group C (46.43%) was higher than that in Groups A (30.67%, P = 0.015) and B (28.30%, P = 0.016). The patients’ liver function recovery and postoperative hospital stay were not significantly different. BIP could decrease intraoperative hemorrhage and postoperative complications compared to CLAMP.

CONCLUSION: Simple saline-coupled BIP should be considered a safe and reliable technique for liver resection to decrease intraoperative hemorrhage and postoperative complications.

Keywords: Hepatectomy; Surgical procedures; Blood loss; Complications; Hospital stay; Comparative study

Core tip: The aim of this clinical study is to recommend a simplified and feasible surgical technique for liver resection. In this study, we found that simple saline-coupled bipolar electrocautery (BIP) could reduce blood loss, blood transfusion and complications compared with clamp crushing. Therefore, saline-coupled BIP can accomplish hepatectomy excellently and would be a safe and reliable technique that is easily applied in liver resection.