Liver transection with pre-coagulation therapy in liver cirrhosis ~ Effective usage of an energy device at hepatectomy ~

Abstract

Hepatectomy for liver cirrhosis patients requires skillful surgical technique and careful attention caused by the fibrotic parenchyma, elevated portal pressure, and impaired coagulation. This report evaluated short- and long-term outcomes for liver cirrhosis patients receiving pre-coagulation therapy on the parenchymal transection plane, as compared to non-coagulation cases. 73 patients diagnosed with cirrhosis via post-operative pathological findings were selected upon reviewing 887 hepatectomy patient files. They were divided into a pre-coagulation group (n=20) and a non-coagulation group (n=53). There were no significant differences in patient and tumor factors between two groups. Pre-coagulation group had significantly less blood loss compared with non-coagulation group [282 vs 563g (p < 0.05)], shorter operative time [214 vs 276min (p = 0.06)], and shorter postoperative hospital stays [14.5 vs 22.5 days (p = 0.12)]. The median recurrence free survival rates time in the pre-coagulation group (733 days) was significantly longer than that in the non-coagulation group (400 days) (p < 0.05). Overall survival rates showed rates showed no difference among the two groups (p = 0.62). Pre-coagulation therapy may be one of the a preferred treatment application for hepatectomy patients with severe liver fibrosis.