AIM:To evaluate the application of bipolar coagulation(BIP)in hepatectomy by comparing the efficacy of BIP alone,cavitron ultrasonic surgical aspirator(CUSA)+BIP and conventional clamp crushing(CLAMP).METHODS:Based on...AIM:To evaluate the application of bipolar coagulation(BIP)in hepatectomy by comparing the efficacy of BIP alone,cavitron ultrasonic surgical aspirator(CUSA)+BIP and conventional clamp crushing(CLAMP).METHODS:Based on our database of patient records,a total of 380 consecutive patients who underwent hepatectomy at our hospital were retrospectively studied for the efficacy of BIP alone,CUSA+BIP and CLAMP.Of all the patients,75 received saline-coupled BIP(Group A),53 received CUSA+BIP(Group B),and252 received CLAMP(Group C).The pre-,mid-,and postoperative clinical manifestations were compared,and the effects of those maneuvers were evaluated.RESULTS:There was no obvious difference among the preoperative indexes between the different groups.The operative time was longer in Groups A and B than in Group C(P<0.001 for both).The amount of bleeding and the rate of transfusion during the operation were significantly higher in Group C than in Groups A and B(P<0.001 for all).The incidence of postoperative complications in Group C(46.43%)was higher than that in Groups A(30.67%,P=0.015)and B(28.30%,P=0.016).The patients’liver function recovery and postoperative hospital stay were not significantly different.BIP could decrease intraoperative hemorrhage and postoperative complications compared to CLAMP.CONCLUSION:Simple saline-coupled BIP should be considered a safe and reliable technique for liver resection to decrease intraoperative hemorrhage and postoperative complications.展开更多
AIM:To evaluate the relationship between donor safety and remnant liver volume in right lobe living donor liver transplantation(LDLT).METHODS:From July 2001 to January 2009,our liver transplant centers carried out 197...AIM:To evaluate the relationship between donor safety and remnant liver volume in right lobe living donor liver transplantation(LDLT).METHODS:From July 2001 to January 2009,our liver transplant centers carried out 197 LDLTs.The clinical data from 151 cases of adult right lobe living donors(not including the middle hepatic vein) were analyzed.The conditions of the three groups of donors were well matched in terms of the studied parameters.The donors' preoperative data,intraoperative and postoperative data were calculated for the three groups:Group 1 remnant liver volume(RLV) < 35%,group 2 RLV 36%-40%,and group 3 RLV > 40%.Comparisons included the different remnant liver volumes on postoperative liver function recovery and the impact of systemic conditions.Correlations between remnant liver volume and post-operative complications were also analyzed.RESULTS:The donors' anthroposomatology data,op-eration time,and preoperative donor blood test indicators were calculated for the three groups.No significant differences were observed between the donors' gender,age,height,weight,and operation time.According to the Chengdu standard liver volume formula,the total liver volume of group 1 was 1072.88 ± 131.06 mL,group 2 was 1043.84 ± 97.11 mL,and group 3 was 1065.33 ± 136.02 mL.The three groups showed no statistically significant differences.When the volume of the remnant liver was less than 35% of the total liver volume,the volume of the remnant had a significant effect on the recovery of liver function and intensive care unit time.In addition,the occurrence of complications was closely related to the remnant liver volume.When the volume of the remnant liver was more than 35% of the total liver volume,the remnant volume change had no significant effect on donor recovery.CONCLUSION:To ensure donor safety,the remnant liver volume should be greater than the standard liver volume(35%) in right lobe living donor liver transplantation.展开更多
文摘AIM:To evaluate the application of bipolar coagulation(BIP)in hepatectomy by comparing the efficacy of BIP alone,cavitron ultrasonic surgical aspirator(CUSA)+BIP and conventional clamp crushing(CLAMP).METHODS:Based on our database of patient records,a total of 380 consecutive patients who underwent hepatectomy at our hospital were retrospectively studied for the efficacy of BIP alone,CUSA+BIP and CLAMP.Of all the patients,75 received saline-coupled BIP(Group A),53 received CUSA+BIP(Group B),and252 received CLAMP(Group C).The pre-,mid-,and postoperative clinical manifestations were compared,and the effects of those maneuvers were evaluated.RESULTS:There was no obvious difference among the preoperative indexes between the different groups.The operative time was longer in Groups A and B than in Group C(P<0.001 for both).The amount of bleeding and the rate of transfusion during the operation were significantly higher in Group C than in Groups A and B(P<0.001 for all).The incidence of postoperative complications in Group C(46.43%)was higher than that in Groups A(30.67%,P=0.015)and B(28.30%,P=0.016).The patients’liver function recovery and postoperative hospital stay were not significantly different.BIP could decrease intraoperative hemorrhage and postoperative complications compared to CLAMP.CONCLUSION:Simple saline-coupled BIP should be considered a safe and reliable technique for liver resection to decrease intraoperative hemorrhage and postoperative complications.
文摘AIM:To evaluate the relationship between donor safety and remnant liver volume in right lobe living donor liver transplantation(LDLT).METHODS:From July 2001 to January 2009,our liver transplant centers carried out 197 LDLTs.The clinical data from 151 cases of adult right lobe living donors(not including the middle hepatic vein) were analyzed.The conditions of the three groups of donors were well matched in terms of the studied parameters.The donors' preoperative data,intraoperative and postoperative data were calculated for the three groups:Group 1 remnant liver volume(RLV) < 35%,group 2 RLV 36%-40%,and group 3 RLV > 40%.Comparisons included the different remnant liver volumes on postoperative liver function recovery and the impact of systemic conditions.Correlations between remnant liver volume and post-operative complications were also analyzed.RESULTS:The donors' anthroposomatology data,op-eration time,and preoperative donor blood test indicators were calculated for the three groups.No significant differences were observed between the donors' gender,age,height,weight,and operation time.According to the Chengdu standard liver volume formula,the total liver volume of group 1 was 1072.88 ± 131.06 mL,group 2 was 1043.84 ± 97.11 mL,and group 3 was 1065.33 ± 136.02 mL.The three groups showed no statistically significant differences.When the volume of the remnant liver was less than 35% of the total liver volume,the volume of the remnant had a significant effect on the recovery of liver function and intensive care unit time.In addition,the occurrence of complications was closely related to the remnant liver volume.When the volume of the remnant liver was more than 35% of the total liver volume,the remnant volume change had no significant effect on donor recovery.CONCLUSION:To ensure donor safety,the remnant liver volume should be greater than the standard liver volume(35%) in right lobe living donor liver transplantation.