Hepatic parenchyma resection using stapling devices: peri-operative and long-term outcome

Area of Science:

• Surgical Oncology
• Hepatobiliary Surgery
• Minimally Invasive Surgery

Background:

• Stapler-assisted hepatectomy is not yet a well-established routine procedure.
• Limited literature exists on its safety and outcomes.
• This study evaluates peri-operative data to assess the method's efficacy.

Purpose of the Study:

• To assess the safety and outcomes of stapler-assisted liver resection.
• To evaluate its feasibility as an alternative to traditional liver transection methods.
• To determine its effectiveness in reducing operative time and controlling bleeding.

Main Methods:

• A retrospective analysis of 62 consecutive liver resection cases using endo GIA vascular staplers.
• Patients included those with hepatocellular carcinoma (HCC), metastatic lesions, and benign liver lesions.
• Procedures involved both major (≥3 segments) and minor hepatic resections.

Main Results:

• Median blood loss was 260 ml, with a median operative time of 150 minutes and transection time of 35 minutes.
• Low complication rates: 3% bile leak, 3% pneumonia, 3% wound infection, 3% pleural effusion.
• Zero peri-operative mortality; 3-year disease-free survival for HCC was 61% and for colorectal metastases was 57%.

Conclusions:

• Stapler-assisted liver resection is a feasible surgical technique.
• It is associated with a low incidence of surgical complications.
• This method serves as a valuable alternative for parenchyma transection, particularly in complex hepatectomies, for reducing operative time and improving hemostasis.