Outcomes of simple saline-coupled bipolar electrocautery for hepatic resection

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.