Experience with a simple clamp-crush technique devoid of other devices for liver resections in a surgical oncology practice

Abstract

BackgroundParenchyma transection techniques during liver resection (LR) are linked to intraoperative blood loss and postoperative morbidity, with a recent increased use of energy devices over traditional clamp-crush hepatotomy (CCH). MethodsProspectively collected data from 191 consecutive patients undergoing LR with exclusive CCH by a single surgeon were examined. ResultsThere were 94 men and 97 women, with 25% primary and 59% secondary malignancies or other conditions (16%). Forty-nine percent of LRs were major, 65% anatomic, and 32% included extrahepatic components. Median Pringle time was 23 minutes (9 to 76), blood loss 300 mL (20 to 5,000), and red blood cell transfusion rate 14%. Morbidity rate was 27% with 6 deaths. Significant relationships were observed for blood loss with complex resections, transfusions, major morbidity, and length of stay, but not between Pringle time and any outcomes. ConclusionA CCH technique as employed in this LR experience without any use of additional devices can yield good postoperative results.