Clinical surgery-InternationalHepatectomy using traditional Péan clamp–crushing technique under intermittent Pringle maneuver
Section snippets
Patients and Methods
Between October 2002 and May 2007, 421 patients underwent liver resection at Juntendo University Hospital. Among them, we reviewed a cohort of 380 adult patients who were considered for elective hepatic resection with the clamp-crushing technique using intermittent Pringle maneuver. There were 119 women and 261 men, with a mean age of 63 ± 11 years (range 21 to 89). Hepatic resection was performed for hepatocellular carcinoma (n = 136), cholangiocellular carcinoma (n = 15), metastatic liver
Results
Surgical data and postsurgical complications for the 380 hepatectomies are listed in Table 2. Eight patients who underwent major hepatectomy and five who underwent minor hepatectomy received perioperative red cell transfusion. Twelve patients who underwent major hepatectomy and nine who underwent minor hepatectomy received perioperative FFP.
The respective incidences of complications by diagnosis are listed in Table 3. After surgery, 91(23.9%) of the 380 patents suffered 106 complications, 88 of
Comments
Effort to improve surgical techniques and minimize intraoperative blood loss can be effective for decreasing postsurgical morbidity and mortality.3, 4 Although some series have demonstrated that blood transfusion–free liver resection is possible, blood transfusion rates for patients undergoing hepatectomy are generally approximately 10% to 40%.1, 2, 15, 16, 17, 18 All of the operations in the present series were performed using the classical clamp-crushing technique with Péan forceps under
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The Prevention of Hepatectomy-Induced Adhesions by Bilayer Sponge Composed of Ultrapure Alginate
2019, Journal of Surgical ResearchCitation Excerpt :In this study, a Pean crush hepatectomy-induced postoperative adhesion model in rats was developed to examine the antiadhesion efficacy of the Alg bilayer sponge. Although the Pean clamp-crushing technique is widely used in clinical hepatic resection,25,26 the postoperative adhesions induced by Pean clamp-crushing hepatectomy have not been evaluated via animal studies. In this animal model, both cut surface and de novo adhesions were developed in rats without material application.
Clinical significance of macroscopic no-margin hepatectomy for hepatocellular carcinoma
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