New Simple Technique for Hepatic Parenchymal Resection Using a Cavitron Ultrasonic Surgical Aspirator® and Bipolar Cautery Equipped with a Channel for Water Dripping

Yamamoto, Yūzō; Ikai, Iwao; Kume, Makoto; Sakai, Yoshiharu; Yamauchi, Akira; Shinohara, Hisashi; Morimoto, Tetsuya; Sugiyama, Yasuyuki; Yamamoto, Masayuki; Yamaoka, Yoshio

doi:10.1007/s002689900619

Cited by 111 publications

(91 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Takasaki et al [32] proposed that rem K ICG > 0.062 is a safety threshold for postoperative mortality [32]. Other investigators also reported that postoperative morbidity was low in patients with rem K ICG > 0.06 after a major hepatectomy [46], or that rem K ICG 0.05 was a threshold for survival in patients with bile duct cancer who underwent preoperative PVE [47]. More recently, on the basis of statistical analysis, a rem K ICG of 0.05 has been again reported as a useful cut-off value for predicting mortality and morbidity in patients with biliary cancer [48,49].…”

Section: Pdr Icg or K Icgmentioning

confidence: 99%

ICG Clearance Test and 99mTc-GSA SPECT/CT Fusion Images

Iimuro¹

2017

Visc Med

View full text Add to dashboard Cite

Preoperative estimation of future remnant liver function is critical for major hepatic surgery to avoid postoperative morbidity and mortality. Among several liver function tests, the indocyanine green (ICG) clearance test is still the most popular dynamic method. The usefulness of ICG clearance test parameters, such as ICGR15, K_ICG, or PDR_ICG, has been reported by many investigators. The transcutaneous non-invasive pulse dye densitometry system has made the ICG clearance test more convenient and attractive, even in Western countries. The concept of future remnant K_ICG (rem K_ICG), which combines the functional aspect and the volumetric factor of the future remnant liver, seems ideal for determining the maximum extent of major hepatic resection that will not cause postoperative liver failure. For damaged livers with functional heterogeneity among the hepatic segments, fusion images combining technetium-99m-diethylenetriaminepentaacetic acid-galactosyl human serum albumin single photon emission computed tomography (99mTc-GSA SPECT) and X-ray CT are helpful to precisely estimate the functional reserve of the future remnant liver. Another technique for image-based liver function estimation, gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid(Gd-EOB)-enhanced magnetic resonance imaging, may be an ideal candidate for the preoperative determination of future remnant liver function. Using these methods effectively, morbidity and mortality after major hepatic resection could be reduced.

show abstract

Section: Pdr Icg or K Icgmentioning

confidence: 99%

ICG Clearance Test and 99mTc-GSA SPECT/CT Fusion Images

Iimuro¹

2017

Visc Med

View full text Add to dashboard Cite

show abstract

“…Hepatic parenchymal dissection was performed using an ultrasonic surgical aspirator and bipolar irrigation forceps [16] . Tumor thrombi confined to the first branch of the portal vein were resected with the liver.…”

Section: Hepatic Resection Techniquementioning

confidence: 99%

Hepatic Resection for Hepatocellular Carcinoma with Tumor Thrombus in the Major Portal Vein

et al. 2015

View full text Add to dashboard Cite

Background: The prognosis of hepatocellular carcinoma (HCC) with tumor thrombus in the major portal vein has been extremely poor. We investigated the outcome of hepatic resection in HCC with major portal vein tumor thrombus (PVTT). Methods: We retrospectively evaluated 52 consecutive patients who underwent hepatic resection for HCC with tumor thrombi in the first branch or trunk of the portal vein. Factors related to disease-free survival (DFS) and overall survival (OS) were analyzed. Results: The median DFS and OS times were 8.9 and 27.6 months for the whole cohort, respectively. Multiple tumors (hazard ratio 2.12; 95% CI 1.11-4.33; p = 0.023), positive surgical margins (hazard ratio 2.45; 95% CI 1.19-4.81; p = 0.016), and non-adjuvant hepatic arterial infusion chemotherapy (HAIC; hazard ratio 2.07; 95% CI 1.11-3.90; p = 0.023) were independent risk factors for DFS. Non-adjuvant HAIC (hazard ratio 1.84; 95% CI 1.01-3.37; p = 0.047) was an independent risk factor for OS. Conclusions: Macroscopically curative resection seems to be of benefit to HCC patients with PVTT, even with tumor thrombi in the first branch or trunk of the portal vein. Adjuvant postoperative HAIC might improve DFS and OS in such patients.

show abstract

“…Advances in technology have elaborated the techniques for parenchymal transection during hepatectomy from the classic clamp crushing technique [18] to a combination of various sophisticated devices [19,20,21]. …”

Section: Discussionmentioning

confidence: 99%

Metzenbaum-Assisted Liver Resection: A Safe and Effective Liver Resection Technique

Schwartz

Miller²,

Roayaie

et al. 2014

Dig Surg

View full text Add to dashboard Cite

Aim: We hereby present and evaluate a technique for hepatic parenchymal transection based on the application of Metzenbaum scissors and clips during liver ischemia. Methods: Our technique was retrospectively evaluated in 32 noncirrhotic, noncholestatic patients with intrahepatic cholangiocarcinoma and 32 patients with hepatocellular carcinoma (23 of whom cirrhotic, 71.9%). Patient data were retrieved from our Hepatobiliary Surgery Database. Type and duration of vascular clamping, blood transfusion requirements, marginal status and immediate postoperative complications were analyzed. Results: Twenty-seven extended (>4 liver segments; 42.2%) and 37 nonextended (≤4 liver segments; 57.8%) liver resections were analyzed. Warm liver ischemia duration was 14 (interquartile range: 11-17.8) min. Thirty-three patients (51.6%) were transfused with a median of 2 (1.5-3) units of packed red blood cells. Tumor-free margins were achieved in 90.6% of cases (n = 58). The overall morbidity rate was 18.8% with a 4.7% mortality rate. Our technique allowed for excellent identification and safe dissection and preservation, or ligation of major liver vessels. Conclusions: The proposed technique is simple, fast, safe and with low cost. It is associated with limited postoperative complications while from an oncologic standpoint it enables the surgeon to achieve a high percentage of tumor-free margins while protecting major vascular structures. i 2014 S. Karger AG, Basel

show abstract

New Simple Technique for Hepatic Parenchymal Resection Using a Cavitron Ultrasonic Surgical Aspirator® and Bipolar Cautery Equipped with a Channel for Water Dripping

Cited by 111 publications

References 4 publications

ICG Clearance Test and 99mTc-GSA SPECT/CT Fusion Images

ICG Clearance Test and 99mTc-GSA SPECT/CT Fusion Images

Hepatic Resection for Hepatocellular Carcinoma with Tumor Thrombus in the Major Portal Vein

Metzenbaum-Assisted Liver Resection: A Safe and Effective Liver Resection Technique

Contact Info

Product

Resources

About