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Journal of Hepato-Biliary-Pancreatic Sciences

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Open Access 01-05-2011 | Original article

Tissue damage with different surgical techniques in a porcine model of liver resection: implications for living-donor liver transplantation?

Authors: Armin Dietmar Goralczyk, Aiman Obed, Angelika große Beilage, Burckhardt Sattler, Laszlo Füzesi, Thomas Lorf

Published in: Journal of Hepato-Biliary-Pancreatic Sciences | Issue 3/2011

Abstract

Background/purpose

For living-donor liver transplantation (LDLT) it is of paramount importance to preserve as much viable liver tissue as possible to avoid postoperative complications in the donor and recipient. The depth of tissue damage caused by common surgical techniques for liver resection has not been studied so far.

Methods

Here we compared the depth of tissue damage and the immunohistochemical expression of heat shock protein (HSP) 70, a marker for tissue damage, in a porcine model of liver resection, to assess the effect of different surgical techniques, i.e., blunt dissection (BD), and dissection with an ultrasound aspirator (UA), an ultrasound scalpel (US), or a water-jet (WJ).

Results

Analysis with linear mixed effects models (LME) showed significantly less tissue damage with BD and UA than with US and WJ (joint p value <0.001). Damage also increased within 6 h after surgery (p value = 0.004). Semiquantitative evaluation of HSP 70 showed increased expression after resection with US compared to all other resection methods (p value <0.001), indicating increased tissue damage with this method.

Conclusion

We suggest that in cases of liver resection for LDLT surgeons should reevaluate using US and WJ because of possible excessive tissue damage compared to BD and UA. Overall we advocate the use of BD as it requires no special equipment and, hence, has considerably higher cost-effectiveness without compromising tissue preservation and clinical outcome and is readily available even in low-tech environments.

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Title: Tissue damage with different surgical techniques in a porcine model of liver resection: implications for living-donor liver transplantation?
Authors: Armin Dietmar Goralczyk
Aiman Obed
Angelika große Beilage
Burckhardt Sattler
Laszlo Füzesi
Thomas Lorf
Publication date: 01-05-2011
Publisher: Springer Japan
Published in: Journal of Hepato-Biliary-Pancreatic Sciences / Issue 3/2011
Print ISSN: 1868-6974
Electronic ISSN: 1868-6982
DOI: https://doi.org/10.1007/s00534-010-0347-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Tissue damage with different surgical techniques in a porcine model of liver resection: implications for living-donor liver transplantation?

Abstract

Background/purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background/purpose

Methods

Results

Conclusion

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