The comparison of efficacy in 3 different types of pre-coagulation method for endoscopic liver resection of hepatocellular carcinoma

Abstract

Background: The control of bleeding from the liver parenchyma in laparoscopic hepatectomy is one of the important issues. In our department, the pre-coagulation method that the preceding coagulation of the resection line was done for the purpose of control of bleeding in parenchymal resection. MCT and RFA have been used for pre-coagulation. Recently, precoagulation by the soft coagulation that provides low voltage congelation under the control of impedance was introduced. In this study, we examined the utility of the different type of pre-coagulation in the laparoscopic hepatic resection.
Methods: The operative outcomes were compared with 55 patients who underwent laparoscopic partial hepatectomy for HCC with pre-coagulation method. The patients were divided into 3 groups depending on pre-coagulation device type, by MCT(M-EH), by RFA(R-EH), and by soft coagulation(S-EH).
Results: The background of patients in each device was not significantly different. The ratio of laparoscopic assisted operation in S-EH coagulation group is higher than the other devices. The intraoperative blood loss and operating time was not significantly different, but percent requiring blood product in M-EH group is higher than R-EH and S-EH coagulation group. Also the complication rate in M-EH group is higher than R-EH and S-EH coagulation group.
Conclusion: Pre-coagulation method by soft coagulation for laparoscopic hepatectomy represents a feasible technique with good control of bleeding. The pre-coagulation by S-EH is one of the choice which can be recommended.