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Article: Current techniques of liver transection

TitleCurrent techniques of liver transection
Authors
Issue Date2007
PublisherInforma Healthcare. The Journal's web site is located at http://www.tandf.co.uk/journals/titles/1365182X.asp
Citation
HPB, 2007, v. 9 n. 3, p. 166-173 How to Cite?
AbstractThe operative mortality rate of liver resection has decreased from 10% to 20% before the 1980s to <5% in most specialized hepatobiliary centers nowadays. The most important factor for better outcome is reduced blood loss due to improvement in surgical techniques. Liver transection is the most challenging part of liver resection, associated with a risk of massive hemorrhage. Understanding the segmental anatomy of the liver and delineation of the proper transection plane using intraoperative ultrasound are prerequisites to safe liver transection. Clamp crushing and ultrasonic dissection are the two most widely used transection techniques. In recent years, new instruments using different types of energy for coagulation or sealing of vessels have been developed for liver transection. These include radiofrequency devices, Harmonic Scalpel, Ligasure and TissueLink dissecting sealer. Whether these new instruments, used alone or in combination with clamp crushing or ultrasonic dissection, improve the safety of liver transection has not been clearly demonstrated. The use of the vascular stapler for transection of major intrahepatic vascular trunks is also gaining popularity. These new instruments are particularly useful in liver transection during laparoscopic liver resection. Adjunctive measures such as intermittent Pringle maneuver and low central venous pressure anesthesia are also useful measures to reduce the risk of hemorrhage. This article reviews the safety and efficacy of different techniques of liver transection, with particular attention to evidence from randomized controlled trials available in the literature.
Persistent Identifierhttp://hdl.handle.net/10722/84304
ISSN
2015 Impact Factor: 2.918
2015 SCImago Journal Rankings: 1.586
References

 

DC FieldValueLanguage
dc.contributor.authorPoon, RTPen_HK
dc.date.accessioned2010-09-06T08:51:21Z-
dc.date.available2010-09-06T08:51:21Z-
dc.date.issued2007en_HK
dc.identifier.citationHPB, 2007, v. 9 n. 3, p. 166-173en_HK
dc.identifier.issn1365-182Xen_HK
dc.identifier.urihttp://hdl.handle.net/10722/84304-
dc.description.abstractThe operative mortality rate of liver resection has decreased from 10% to 20% before the 1980s to <5% in most specialized hepatobiliary centers nowadays. The most important factor for better outcome is reduced blood loss due to improvement in surgical techniques. Liver transection is the most challenging part of liver resection, associated with a risk of massive hemorrhage. Understanding the segmental anatomy of the liver and delineation of the proper transection plane using intraoperative ultrasound are prerequisites to safe liver transection. Clamp crushing and ultrasonic dissection are the two most widely used transection techniques. In recent years, new instruments using different types of energy for coagulation or sealing of vessels have been developed for liver transection. These include radiofrequency devices, Harmonic Scalpel, Ligasure and TissueLink dissecting sealer. Whether these new instruments, used alone or in combination with clamp crushing or ultrasonic dissection, improve the safety of liver transection has not been clearly demonstrated. The use of the vascular stapler for transection of major intrahepatic vascular trunks is also gaining popularity. These new instruments are particularly useful in liver transection during laparoscopic liver resection. Adjunctive measures such as intermittent Pringle maneuver and low central venous pressure anesthesia are also useful measures to reduce the risk of hemorrhage. This article reviews the safety and efficacy of different techniques of liver transection, with particular attention to evidence from randomized controlled trials available in the literature.en_HK
dc.languageengen_HK
dc.publisherInforma Healthcare. The Journal's web site is located at http://www.tandf.co.uk/journals/titles/1365182X.aspen_HK
dc.relation.ispartofHPBen_HK
dc.rightsHPB: the official journal of the IHPBA. Copyright © Informa Healthcare.en_HK
dc.titleCurrent techniques of liver transectionen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=1365-182X&volume=9&issue=3&spage=166&epage=173&date=2007&atitle=Current+techniques+of+liver+transectionen_HK
dc.identifier.emailPoon, RTP: poontp@hkucc.hku.hken_HK
dc.identifier.authorityPoon, RTP=rp00446en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1080/13651820701216182en_HK
dc.identifier.scopuseid_2-s2.0-34250655743en_HK
dc.identifier.hkuros133222en_HK
dc.identifier.hkuros141076-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-34250655743&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume9en_HK
dc.identifier.issue3en_HK
dc.identifier.spage166en_HK
dc.identifier.epage173en_HK
dc.publisher.placeUnited Kingdomen_HK
dc.identifier.scopusauthoridPoon, RTP=7103097223en_HK

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