Outcome and Complications of Crush Clamp and Ultrasonic Dissection Techniques in Hepatectomy of Patients With Hepatic Mass

Document Type : Original Article

Authors

1 Department of Surgery, School of Medicine, Jundishapur University of Medical Sciences, Ahvaz, Iran

2 Department of Surgery, School of Medicine, Jundishapur University of Medical Sciences, Ahvaz, Iran.

10.32598/jjo.20.2.5

Abstract

Objectives: Perioperative hemorrhage and postoperative bile leakage are important
complications of hepatectomy. Various methods have been reported to reduce intraoperative
bleeding during liver transection. We designed a randomized clinical trial to
compare the outcomes and complications between Crush Clamp (CC) and ultrasound
dissection methods (the Cavitron Ultrasonic Surgical Aspirator, CUSA) in liver transection.
Methods: Twenty patients underwent hepatectomy with the crush clamp method, and
20 underwent ultrasonic dissection. The surgical outcome and complications, including
duration of the surgery, bleeding, packed cells requirement after the operation, bile
leakage, hospital stay, and hepatic failure, were evaluated and compared.
Results: Mean blood loss during the operation in the CUSA group was less than CC
group, but this loss was not significant (247±77.1 in CC vs 232.2±84.3 mL in CUSA,
P=0.769). The operation time in the CC group was longer than in the CUSA group,
but this difference was not significant (171.3±55.1 min in CC vs 163.1±74.2 min in
CUSA; P=0.72). The duration of transection in patients of the CC group was significantly
less than that in the CUSA group (47.5±21.1 min for CC vs 77.6±30.4 min for CUSA,
P=0.06), and the length of hospitalization in the CC group was significantly less than
CUSA group (1.9±0.7 day for CC vs 2.8±1.1 day for CUSA, P=0.016). There were no
cases of infection and bile leakage in the two groups.
Discussion: Postoperative complications did not differ in the two groups, but the
duration of transection in crush clamp was shorter than the ultrasonic dissection method,
and blood loss was almost identical. Because ultrasonic dissection is an equipmentdependent
procedure and more expensive, we tend to perform liver transection with the
crush clamp method.

Highlights

Amin Bahreini (PubMed)(Google Scholar)

Khalil Kazemnia (PubMed)(Google Scholar)

Keywords


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Bahreini