Practical usefulness of bipolar scissors in hepatectomy

Area of Science:

• Hepatobiliary Surgery
• Surgical Oncology
• Minimally Invasive Techniques

Background:

• Hepatocellular carcinoma (HCC) patients with chronic liver dysfunction require careful management during hepatectomy to minimize surgical stress.
• Reducing intraoperative blood loss and liver injury is crucial for preserving patient quality of life.
• Conventional hepatectomy methods, including crushing clamp and microwave cauterization, were used prior to 1998.

Purpose of the Study:

• To compare the effectiveness of bipolar scissors versus conventional methods in reducing surgical stress during hepatectomy for HCC.
• To evaluate the impact of bipolar scissors on intraoperative blood loss and liver injury.

Main Methods:

• Retrospective comparison of 53 patients with TNM stage I/II HCC undergoing partial hepatectomy between 1996 and 1999.
• Group CM (n=32): Conventional method (1996-1997).
• Group BS (n=21): Bipolar scissors (1998-1999).

Main Results:

• Group BS showed significantly lower blood loss (641 mL vs. 1112 mL) and transfusion requirements (100 mL vs. 450 mL) compared to Group CM.
• Fewer patients in Group BS (19%) experienced blood loss exceeding 1000 mL versus Group CM (47%) (P=0.04).
• Intraabdominal drainage duration was shorter in Group BS (9.0 days) than in Group CM (15.0 days) (P=0.01).

Conclusions:

• Bipolar scissors are superior to conventional methods in decreasing blood loss and liver injury during hepatectomy for HCC.
• The findings support the use of bipolar scissors for improved patient outcomes in liver surgery.
• A prospective randomized study is warranted to further validate these results.