Premium
Silkclasy: A simple way for liver transection during anatomic hepatectomies
Author(s) -
Herman Paulo,
Machado Marcel Autran C.,
Machado Marcel C.C.
Publication year - 2006
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.20613
Subject(s) - medicine , hepatectomy , blood loss , clamp , surgery , parenchyma , resection , liver parenchyma , radiology , pathology , mechanical engineering , clamping , engineering
Background Parenchymal transection is the most important step of liver resection, and during this phase, blood loss may lead to morbidity and mortality. Liver parenchyma can be transected by different ways such as finger fracture, clamp crushing, or instrument‐based techniques. Methods A simple and cost‐efficient method has been developed for liver transection using a technique based on silk crushing of the liver substance. Results We have successfully employed this technique in 278 consecutive liver resections from July 2001 to March 2006. The average duration of hepatic transection varied according to the type of liver resection: 22 min (range 15–42), 19 min (range 11–37), and 12 min (range 7–21) for right hepatectomy, left hepatectomy, and bisegmentectomy 2‐3, respectively. The mean transection speed was 6.9 ± 2.3 cm 2 /min. Blood transfusions were necessary in 42 patients (15.1%), and there were three operative deaths (1.1%). Morbidity rate was 20.9% (58 patients). Conclusions This technique allows a safe and quick liver transection without the use of expensive hemostatic devices, and also precludes the use of inflow occlusion maneuvers. We recommend the use of this technique in centers with low economic resources. J. Surg. Oncol. 2007;95:86–89. © 2006 Wiley‐Liss, Inc.