Dissektionstechniken in der Leberchirurgie

Rau, H. G.; Schauer, R.; Pickelmann, Sven; Beyer, Benoît; Angele, Martin K.; Zimmermann, Alexander; Meimarakis, G.; Heizmann, Oleg; Schildberg, F. W.

doi:10.1007/s001040051277

Cited by 35 publications

(16 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The same results can be obtained with laparoscopy and stapler for unroofing of hepatic cysts since any inadvertently injured bile duct or blood vessel is sealed. Stapling devices can be especially useful in patients with coagulopathy and in the treatment of complex liver abscesses [14,15,16, 19, 31]. However, it was only most recently that a large series of staplers being used for the phase of parenchymal transection for liver resection was published.…”

Section: Discussionmentioning

confidence: 99%

The Use of Endo-GIA Vascular Staplers in Liver Surgery and Their Potential Benefit:A Review

et al. 2007

View full text Add to dashboard Cite

Stapling devices have been introduced for safety and to reduce the overall operative time in many surgical procedures. In hepatobiliary surgery, i.e. liver resection, several types of staplers are in use. While transection of hepatic vessels with vascular staplers is well established, their use in dissecting hepatic parenchyma has only been assessed recently. Its advantages were especially a low rate of biliary complications (i.e., bile fistulas, bilioma) and reduced bleeding. As expected, the operative time was decreased dramatically while both the complication rate in general and the overall costs for stapler hepatectomy were comparable with other techniques used in high-volume centers. Thus, endo-GIA vascular staplers can be safely used to dissect the hepatic parenchyma in a routine clinical setting with low incidence of surgical complications.

show abstract

Section: Discussionmentioning

confidence: 99%

The Use of Endo-GIA Vascular Staplers in Liver Surgery and Their Potential Benefit:A Review

et al. 2007

View full text Add to dashboard Cite

show abstract

“…Im eigenen Vorgehen erfolgt die Parenchymdissektion meist stumpf mit den Branchen einer Schere unter fortlaufender (Durchstechungs-)Ligatur (ggf. Clips) der durch die Resektionsebene verlaufenden Gefäße [2,18,21] [4,12,16,19]. Nach Abschluss der "chirurgischen" Blutstillung können Fibrinkleber, ein Kollagenvlies oder sonstige 7 Hämostyptika auf die Resektionsfläche aufgetragen werden.…”

Section: Parenchymdissektionunclassified

Technik der Leberresektion

Lang

2007

Chirurg

View full text Add to dashboard Cite

Hepatic surgery has grown considerably in importance during the last two decades. Major roles in this development have been played by improvements in imaging diagnostics and intensive care and particularly advancements in general hepatic surgical techniques. We present the terminology of functional and segmental anatomy of the liver on which current hepatic surgery is based, along with operative strategies for standard, nonconventional, and repeat resections. Intraoperative complications are also discussed.

show abstract

“…Nachdem ab Ende 1995 erste kommerzielle Geräte verfügbar waren, wurde diese Technik sukzessive häufiger eingesetzt und ist heute unser Standard-Dissektionsverfahren. Die Wahl der Wasserstrahl-Dissektion gründet sich auf die Daten von 591 Patienten einer klinischen Vergleichsstudie, deren Ergebnisse fortlaufend veröffentlicht wurden [35,36]. So konnte gezeigt werden, dass die Dissektionstechnik auch bei ausgedehnteren Resektionen in der Kaplan-Meier-Analyse keinen Einfluss auf die Überlebenszeit nach Metastasenresektion hatte (Abb.…”

Section: Klinische Studie Zum Vergleich Der Dissektionstechnikenunclassified

Standards in der Operationstechnik bei Lebermetastasen

Rau¹,

Zimmermann²,

Wardemann³

et al. 2003

Visc Med

Self Cite

View full text Add to dashboard Cite

Standards of Surgical Techniques in Liver Metastases The first posttraumatic liver resection was performed in the 17th century. Since then almost 200 years have passed until the first elective liver resection was performed in 1888 and the first hemihepatectomy was achieved in 1911 by Wendell. It was quickly evident that almost 70% of the time required for a successful liver resection was needed for the anatomical preparation and only 20% of the time for parenchymal resection. Since this time a wide variety of dissection techniques have been introduced. The blunt dissection was replaced by novel methods, i.e. CUSA® technique, and the Jet-Cutter for major liver resections. These methods represent selective dissection techniques, whereas nonselective methods include the scalpel, scissors, linear stapling cutter, high-frequency coagulation, and the laser technique. The aim of this review is to compare the different resection techniques in liver surgery, focusing on blood loss and resection time. A clinical study compared blood loss, resection time, and Pringle time between the different dissection techniques (blunt dissection n = 279, CUSA, n = 175 and Jet-Cutter n = 137). Parenchymal resection performed via Jet-Cutter showed a significant lower blood loss and shorter resection and Pringle time in comparison to the other resection techniques. Moreover, extrahepatic control of liver perfusion and of the liver veins and the surgeon’s experience are important for lowering blood loss during liver resection. The aim of this review is the comparison of the different resection techniques in liver surgery focusing on blood loss and resection time.

show abstract

Dissektionstechniken in der Leberchirurgie

Cited by 35 publications

References 15 publications

The Use of Endo-GIA Vascular Staplers in Liver Surgery and Their Potential Benefit:A Review

The Use of Endo-GIA Vascular Staplers in Liver Surgery and Their Potential Benefit:A Review

Technik der Leberresektion

Standards in der Operationstechnik bei Lebermetastasen

Contact Info

Product

Resources

About