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A silicone disc for liver retraction in laparoscopic gastrectomy reduces the postoperative increase in the liver enzyme level

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Abstract

Purpose

To compare changes in liver enzyme levels on postoperative day 1 between patients with and without silicone disc (SD) use during liver retraction in laparoscopic gastrectomy for gastric cancer and laparoscopic gastric mobilization for esophageal cancer.

Methods

This prospective randomized controlled phase II trial was conducted between June 30, 2020, and November 30, 2022, to investigate the benefits of using an SD with a Nathanson liver retractor (NLR) compared with those using an NLR in laparoscopic gastrectomy and gastric mobilization. The primary endpoint was the change in transaminase level on postoperative day 1.

Results

A total of 86 patients received randomized assignments and were included in the analysis, with 44 assigned to the SD (–) group and 42 to the SD (+) group. On postoperative day 1, the SD (+) group showed a significantly lower increase in the aspartate aminotransferase levels than the SD (–) group (SD [+], 94.4% vs. SD [–], 179.8%; p = 0.012). Similarly, the SD (+) group showed a significantly lower increase in alanine aminotransferase levels than the SD (–) group (SD [+], 71.6% vs. SD [–], 201.5%; p = 0.014).

Conclusion

In laparoscopic gastrectomy, the use of an SD combined with an NLR appears to mitigate postoperative liver dysfunction.

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Acknowledgements

The authors gratefully acknowledge the cooperation of all participants in this study.

Funding

No external funding was received for the study.

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Authors and Affiliations

  1. Department of Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Chuo-ku, Hamamatsu City, Shizuoka, 431-3192, Japan

    Wataru Soneda, Eisuke Booka, Ryoma Haneda, Sanshiro Kawata, Tomohiro Murakami, Tomohiro Matsumoto, Yoshifumi Morita, Hirotoshi Kikuchi & Hiroya Takeuchi

  2. Department of Perioperative Functioning Care and Support, Hamamatsu University School of Medicine, 1-20-1 Handayama, Chuo-ku, Hamamatsu City, Shizuoka, 431-3192, Japan

    Yoshihiro Hiramatsu

Authors
  1. Wataru Soneda
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  2. Eisuke Booka
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Correspondence to Eisuke Booka.

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Soneda, W., Booka, E., Haneda, R. et al. A silicone disc for liver retraction in laparoscopic gastrectomy reduces the postoperative increase in the liver enzyme level. Surg Today (2024). https://doi.org/10.1007/s00595-024-02834-w

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