Microsurgical Hepatic Artery Reconstruction Using Ikuta A-II Double Clamp

Area of Science:

• Vascular Surgery
• Transplantation Surgery
• Surgical Instrumentation

Background:

• Hepatic artery (HA) reconstruction is a critical step in living donor liver transplantation.
• Ensuring the integrity of the HA anastomosis is essential to prevent complications such as thrombosis and ischemia.
• Conventional vascular clamps may lead to challenges during HA reconstruction, necessitating additional interventions.

Observation:

• A study compared the Ikuta type A-II vascular clamp with conventional clamps in 24 patients undergoing HA reconstruction.
• The Ikuta type A-II clamp was used in 6 patients, while conventional clamps were used in 18 patients.
• No blood leakage or HA thrombosis occurred in the Ikuta A-II group, and no additional clamps were required.

Findings:

• Patients using the Ikuta type A-II clamp experienced no blood leakage or HA thrombosis.
• Sixteen of 18 patients (88.9%) using conventional clamps required an additional vascular clamp due to leakage.
• The Ikuta type A-II clamp demonstrated significantly better performance in preventing leakage compared to conventional clamps (p < 0.001).

Implications:

• The Ikuta type A-II vascular clamp is a safe and effective tool for HA reconstruction in liver transplantation.
• Its use can potentially reduce operative time and complications associated with HA anastomosis.
• This finding supports the adoption of the Ikuta type A-II clamp in liver transplant centers to improve surgical outcomes.