Simplified inflow control using stapling devices for major hepatic resection
K. Yanaga, T. Nishizaki, K. Yamamoto, A. Taketomi, T. Matsumata, K. Takenaka and K. Sugimachi
Department of Surgery II, Kyushu University Faculty of Medicine, Fukuoka, Japan.
We describe the efficacy of a new technique for hepatic inflow division
using stapling devices in major hepatic resections. We studied 28
consecutive patients who underwent major hepatic resection at a tertiary
referral center by en masse inflow control of Glisson's pedicle in 1993 and
1994, of whom 10 underwent inflow control with stapling devices. Although
stapling devices were used for larger tumors (mean +/- SD, 12.2 +/- 8.6 vs
5.7 +/- 5.0 cm; P = .02), the operation time (261 +/- 57 vs 301 +/- 143
minutes), operative blood loss (2071 +/- 1318 vs 4792 +/- 6586 mL),
postoperative intra-abdominal bleeding (0% [0/10] vs 17% [3/18]), and
hospital stay (16.0 +/- 2.6 vs 20.6 +/- 7.4 days) were favorable for
resections with staplers vs resections without staplers; the overall
incidences of postoperative complications (40% [4/10] vs 39% [7/18]) and
hospital death (10% [1/10] vs 6% [1/18]) were comparable in the two groups.
We conclude that stapling devices allow simple, quick, and safe en masse
inflow control in major hepatic resections.
