Randomized Comparison of Ultrasonic vs Clamp Transection of the Liver

Abstract

IN LIVER surgery, transection of the hepatic parenchyma is a technical priority because blood loss during the procedure is a powerful determinant of operative outcome.¹ At high-volume centers, partial hepatectomy has been reported to yield a median blood loss of 700 to 1200 mL,^2-7 morbidity rates of 23% to 46%,^2-8 and mortality rates of less than 4%.^2-9 The hepatic parenchyma can be transected by conventional digitoclasia (finger fracture or clamp crushing)¹⁰ or with instrument-based techniques (ultrasonic or water jet dissector).¹¹ The procedure used is likely to depend on the surgeon's training or preference rather than on objective data.