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Bloodless liver resection using radiofrequency energy
Ahmet Ayav1, Long R Jiao, Nagy A Habib
1Department of Surgical Oncology, Imperial College London, Faculty of Medicine, Hammersmith Campus, London, UK.
Background:
Liver surgery carries the risk of intraoperative bleeding. In order to avoid bleeding, transection of the liver can be performed after coagulating the parenchyma by using monoplolar or bipolar radiofrequency energy.
Methods:
236 consecutive patients underwent liver resection with the radiofrequency-assisted technique using either a monopolar or a bipolar device. Data were collected prospectively to assess the outcome including, intraoperative blood loss, blood transfusion requirement, morbidity and mortality rates.
Results:
There were 41 major hepatectomies and 195 minor resections. Overall mean intraoperative blood loss was 157 +/- 240 ml, while mean blood loss during liver transection was 90 +/- 105 ml. 10 patients (4%) received blood transfusion. 50 patients (21%) developed postoperative complications including 5 bile leaks (2%). The mortality rate was 2.1%. No patient was reoperated for postoperative haemorrhage or bile leak. The mean postoperative stay was 11 +/- 10 days.
Conclusion:
The radiofrequency-assisted liver resection technique offers hepatobiliary surgeons an additional method for performing liver resections with minimal blood loss, low transfusion requirement, and low morbidity and mortality rates.
