Hepatectomy with microwave tissue coagulator: with special reference to combination of hemi-or total hepatic vascular occulusion

Abstract

We investigated the advantage to hepatectomy with combination of microwave tissue coagulator (MTC) and hepatic vascular occulusion. Fourty one consecutive patients undergoing hepatic resection by our method were evaluated with references to comparison of reported hepatectomized cases using MTC without hepatic vascular clamp. We performed microwave coagulation only along the intended liver surface resection line and no more, then urtrasonically guided liver resection initiated along with coagulated line by forceps frature method with intermittent vasucular occulusion. The efficacy of MTC in hepatectomy, as many authors reported, was reduction in blood loss during operation without vasucular clamp i.e. warm ischemia of the liver which regarded as contraindicates to dameged liver. This 41 consecutive liver resections consisted of partial (Hr0 : 13), subsegmental (Hr1 : 13), segmental (Hr1 : 8), lobar (Hr2 : 1), extended lobar (Hr2 + : 1). In this study, the cases of postoprerative intrperitoneal infection, bile lekage, hemorrhage, was one respectively (2.4%) and ascites were 2 cases (4.9%), pleural effusion were 3 cases (7.3%). The average amount of blood loss was 763 ± 110 ml and average volume of resected liver was 194 ± 209g. The post operative laboratory data related to liver function changed within accepatable range reasonable for operative magnitude. Intraperative blood loss, postoperative complications' rates, postoperarive clinical courses were all not only diferent with using MTC without hepatic clamp but also more favorable results. No complications attributable to combined usage of MTC and vascular clamp were emerged.We concluded that combination of MTC and hepatic vascular occlusion was very useful for safer hepatic resection.