Five-staplers method with vascular closure device for right hemihepatectomy via anterior approach

Abstract

Objective To investigate the clinical application value of five-staplers method with vascular closure device for right hemihepatectomy via anterior approach. Methods Twenty-four patients with primary liver cancer who underwent right hemihepatectomy in the First People's Hospital of Foshan between January 2014 and June 2016 were enrolled in this prospective study. According to surgical methods, the patients were divided into the five-staplers method group (n=11) and control group (n=13). In the five-staplers method group, 11 cases were all males, aged (46±6) years old on average, and underwent right hemihepatectomy via anterior approach with five-staplers method. In the control group, 11 cases were males and 2 were females, aged (52±14) years old on average, and underwent right hemihepatectomy via anterior approach with traditional method. The informed consents of all patients were obtained and the local ethical committee approval was received. The general data, intraoperative and postoperative conditions were compared between two groups. The data such as the operation time and liver division time in two groups were compared using t test. Results Extra-Glissonean sheath dissection of the right hepatic pedicle for the hemi-hepatic flow occlusion was performed in the five-staplers group. While intra-Glissonean sheath dissection of the vessels and bile duct of the right liver lobe was performed in the control group, including 3 cases of Pringle maneuver. The operation time and liver division time in the five-staplers group was respectively (262±49) and (40±8) min, significantly shorter than (325±67) and (92±15) min in the control group (t=-2.255, -11.072; P 0.05). No postoperative complications, such as rebleeding and bile leakage or surgery-related death was observed in two groups. Conclusions Five-staplers method with vascular closure device is a safe, simple, convenient and rapid method for right hemihepatectomy via anterior approach. Compared with the traditional method, it can shorter the operation time and liver division time, lower the intraoperative blood loss without increasing the postoperative length of hospital stay and incidence of postoperative complications. Key words: Vascular closure device; Hepatectomy; Right hemihepatectomy via anterior approach; Five stapler; Liver neoplasms