Bloodless Liver Resection Assisted by Radiofrequency Ablation for Hepatectomy
|Course||Hepatobiliary and Pancreatic Surgery|
|Keywords||Liver tumor radiofrequency ablation hepatecomy intraoperative blood loss|
Objective:To research the feasibility, safety and effectiveness of bloodless liver resection assisted by radiofrequency ablation for hepatectomy. Summary the surgical techniques and clinical value of the bloodless liver resection assisted by radiofrequency.Methods:In this retrospective study from January 2010 to December 2010,38 cases underwent liver resection, in these patients,20 cases undergoing bloodless, liver resection assisted by radiofrequency ablation and 18cases undergoing hepatectomy by curettage and aspiration served as controls. Clinical data including operative time, liver resection time, intraoperative blood loss, liver resection blood loss, portal, triad clamping time, hospitalization are compared between the two groups.Results:The clinicopathological characteristics before operation both groups were similar. No significant differences were found in age (y) (54.70±11.20 VS 54.83±13.00, P>0.05), cirrhosis (65.00%VS 61.11%, P>0.05), tumor diameter (cm) (4.942±3.189 VS 7.045±4.735, P>0.05). Bloodless liver assisted by radiofrequency ablation was successfully performed on these 20 cases. Curettage and aspiration was performed on the others. The mean liver resection time between the bloodless liver resection group and curettage and aspiration group was respectively (31.05±9.939) min and (40.22±12.18) min, there is significant difference (P＜0.05). The mean portal triad clamping time was (7.000±7.462) min and (19.00±18.96) min respectively, there is significant difference(P<0.05). The mean intraoperative blood loss was (425.0±269.3) ml and (838.9±735.0) ml, there is significant difference (P<0.05).The mean liver resection blood loss was (61.00±42.54) ml and (263.9±248.0)ml respectively, there is significant difference (P＜0.05). While the mean operative time was (165.05±39.03) min and(144.28±36.24)min respectively, there is no significant difference(P=0.0988). The mean hospitalization was (14.30±4.181) d and (14.11±5.075) d respectively, no significant difference was found(p=0.5317). There was no mortality and there were no significant post-operative complications such as bile leakage, bleeding in both groups. The transient fever was no significant difference (55.00%VS 33.33%, P>0.05). All patients were followed up for 3～12 months, there were 3 patients recurrence in bloodless liver resection group,1 patient recurrence in curettage and aspiration group, the recurrence rate was respectively 15.00%and 5.56%, there was no significant difference between the two groups(P=0.6062).Conclusions:With experienced hepatobiliary pancreatic surgical skills and full pre-operative preparations, bloodless liver resection assisted by radiofrequency ablation is feasible, safe and effective, also is associated with significantly shorter operative and liver resection time, less intraoperative and liver resection blood loss, shorter portal triad clamping time. The hospitalization time in both groups is not different.