Application value of cavitron ultrasonic surgical aspirator combined with high-frequency electrosurgical scalpel in liver graft procurement for living donor liver transplantation

Abstract

Objective To explore the application value of cavitron ultrasonic surgical aspirator (CUSA) combined with high-frequency electrosurgical scalpel in liver graft procurement for living donor liver transplantation (LDLT). Methods Clinical data of 8 donors who underwent LDLT in Zhengzhou People's Hospital between May 2012 and July 2015 were retrospectively analyzed. CUSA combined with high frequency electrosurgical scalpel were used in the liver graft procurement of all the donors. Among the donors, 4 were males and 4 were females with the age ranging from 30 to 56 years old and the median of 45 years old. The informed consents of all donors were obtained and the local ethical committee approval was received. During the graft procurement, the liver was fully dissociated, and the first porta hepatis was dissected without blood occlusion. Blood vessel distribution and liver resection line were determined by intraoperative ultrasound examination. Liver capsule was incised with high frequency electrosurgical scalpel and liver parenchyma was seperated with CUSA. The length of operation, intraoperative blood loss, changes of liver function and length of stay after operation, incidence of complications and perioperative mortality of the donors were observed. All the donors were followed up after operation. Results All donors completed the operations successfully. Six cases underwent right hemihepatectomy and one of them had middle hepatic vein resected. Two cases underwent left hemihepatectomy without resecting the middle hepatic vein. The average length of operation was (437±96) min and the intraoperative blood loss was (467±216) ml. No blood transfusion during operation was observed. The serum alanine aminotransferase (ALT) level was respectively (221±56) and (77±25) U/L, and the serum total bilirubin (TB) level at 1, 7 d after operation was respectively (34±11) and (16±6) μmol/L. The length of stay after operation was (18±5) d. Fat liquefaction of wound after operation was observed in 1 case and was cured after conservative treatment. No death was observed. Conclusions CUSA combined with high frequency electrosurgical scalpel has certain clinical application value in the liver graft procurement for LDLT. It is a safe and effective method for liver graft procurement. Key words: Liver transplantation; Living donors; Cavitron ultrasonic surgical aspirator; High frequency electrosurgical equipment