Liver Parechyma Crushing with Clamp is Superior to Crushing by LigaSure in Terms of Early Local Recu

Abstract

Background: Liver transection consists of two elements, crushing of the liver parenchyma and sealing of the remaining tissue. We aimed to investigate the influence of the technique used for crushing liver parenchyma on clinical outcomes in patients with hepatocellular carcinoma (HCC). Methods: We investigated data from 65 consecutive patients who underwent open hepatectomy for HCC between January 2012 and December 2018. Patients were divided into two groups based on the technique used for crushing liver parenchyma, defined as the direct LigaSure crushing group (DLC group) and clamp-crushing following LigaSure sealing group (CC group). Results: The direct LigaSure crushing method was associated with a higher rate of early local recurrence than the clamp-crushing method (DLC group vs. CC group, 31.6% vs. 11.1%, p = 0.46). A multivariable analysis revealed that estimated blood loss, liver transection method, number of tumors, and curative resection were independent risk factors associated with early local recurrence. There was one case in which hepatectomy was performed along the surface of the HCC using the direct LigaSure crushing method, and pathological analysis indicated potential tumor dissemination caused by cauterization of the surface of the tumor Conclusions: The clamp crushing method may reduce early local recurrence compared with the direct LigaSure crushing method after hepatectomy in HCC patients.