Major bile duct injury resulting from radiofrequency-assisted hepatectomy

Radiofrequency parenchymal coagulation of the hepatic parenchyma prior to division is increasingly being used as an adjunct for reducing blood loss during the parenchymal transection phase of hepatectomy. However, recent reports have suggested that radiofrequency techniques result in an increased number of complications and liver damage compared to the clamp-crush technique. We believe this is a first report of a major hilar bile duct injury, a severe complication of RF-assisted hepatectomy, resulting from use of a monopolar device and discusses the merits of bipolar over monopolar RF electrode configuration when used to pre-coagulate liver tissue prior to transection. Our case underscores the need for judicious use of radiofrequency energy devices, particularly for liver resections that involve central transection planes.