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01-02-2017 | Original Article

Spray Diathermy Versus Harmonic Scalpel Technique for Hepatic Parenchymal Transection of Living Donor

Authors: Mohamed El Shobary, Tarek salah, Ayman El Nakeeb, Ahmad M. Sultan, Ahmed Elghawalby, Omar Fathy, Mohamed Abdel Wahab, Amro Yassen, Mohamed Elmorshedy, Wagdi F. Elkashef, Usama Shiha, Mohamed Elsadany

Published in: Journal of Gastrointestinal Surgery | Issue 2/2017

Abstract

Background

Liver parenchymal transection is the most invasive and challenging part in the living donor operation. The study was planned to compare the safety, efficacy, and outcome of harmonic scalpel versus spray diathermy as a method of parenchymal liver transection in donor hepatectomy.

Patient and Method

Eighty consecutive patients, who were treated by living donor liver transplantation (LDLT), were included in the study. The study population was divided into two groups according to the method of liver transection: group A by harmonic scalpel (HS) and group B by spray diathermy (SD). The primary outcome was the volume of blood loss during transection. Secondary outcomes were time of transection, number of ligatures needed during transection, pathological changes at cut surface, postoperative morbidities, cost, and hospital stay

Results

Blood loss during overall liver transection and in each zone was significantly less in the SD than in the HS group (P = 0.015). The number of ligatures was significantly less in the SD than in the HS group (P = 0.0001). The SD group had significantly higher level of serum bilirubin, serum glutamic pyruvic transaminase (SGPT), and international normalized ratio (INR) levels on postoperative day 3 than the HS group. Lateral tissue coagulation and hepatic necrosis are significantly less in HS group. The overall incidence of postoperative morbidities was the same in both groups. The cost was higher in HS group than SD group (US$760 vs. US$40 P = 0.0001).

Conclusion

Spray diathermy is an effective method of parenchymal transection with significantly lower blood loss and lower cost compared to HS with no increase in morbidity. HS is associated with earlier recovery of liver functions.

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Title: Spray Diathermy Versus Harmonic Scalpel Technique for Hepatic Parenchymal Transection of Living Donor
Authors: Mohamed El Shobary
Tarek salah
Ayman El Nakeeb
Ahmad M. Sultan
Ahmed Elghawalby
Omar Fathy
Mohamed Abdel Wahab
Amro Yassen
Mohamed Elmorshedy
Wagdi F. Elkashef
Usama Shiha
Mohamed Elsadany
Publication date: 01-02-2017
Publisher: Springer US
Published in: Journal of Gastrointestinal Surgery / Issue 2/2017
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-016-3312-y

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Spray Diathermy Versus Harmonic Scalpel Technique for Hepatic Parenchymal Transection of Living Donor

Abstract

Background

Patient and Method

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Patient and Method

Results

Conclusion

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