Zhao YJ, et al. – The BiClamp device was examined for its feasibility and safety for open liver resection. BiClamp was a reusable vessel–sealing device. Even in patients with cirrhotic liver, this device permitted safe and feasible major and minor hepatectomy.

Methods

• 84 patients undergoing liver resection were selected from a single centre, with all patients operated by the same surgical group.
• BiClamp (Erbe Elektromedizin GmbH, Tubingen, Germany), an electrosurgical device that simultaneously transects liver parenchyma and seals vessels <7 mm in diameter was employed to perform all hepatectomies.
• Data was collected on intraoperative blood loss, resection time, and perioperative complications, comparing cirrhotic and non-cirrhotic patients.

Results

• This study incorporated 84 patients included 56 cirrhotic and 28 non-cirrhotic patients.
• It was reported that all patients underwent hepatectomy (30 major and 54 minor hepatectomies) using the BiClamp, exclusively, and 54 patients required inflow occlusion (Pringle manoeuvre).
• As per the findings, overall intraoperative blood loss (mean ± standard deviation) was 523.5 ± 558.6 ml, liver parenchymal transection time was 36.3 ± 16.5 min (range, 13-80 min), and the mean parenchymal transection speed was 3.0 ± 1.9 cm2/min.
• Perioperative blood transfusion was given to twelve patients.
• 800 RMB (approximately 109€) was the cost of BiClamp for each patient.
• No deaths were reported, and the morbidity rate was 25%.
• In addition, the mean (standard deviation) hospital stay was 9.3 (2.3) days.
• No difference was observed in blood loss (491.0 ± 535.7 ml vs 588.8 ± 617.5 ml, P = 0.598), liver parenchymal transection time (34.1 ± 14.8 min vs 40.9 ± 19.2 min, P = 0.208), mean parenchymal transection speed (3.3 ± 2.1 cm2/min vs 2.5 ± 1.3 cm2/min, P = 0.217), and operative morbidity (28.6% vs 14.3%, P = 0.147), by comparisons between cirrhotic and non-cirrhotic patients.