Usefulness of Kelly clamp crushing technique during hepatic resection

Abstract

Introduction: Recently, there are various kinds of parenchymal transection methods. The aim of this study is to evaluate the usefulness of the Kelly clamp crushing technique compared to ultrasonic dissector during hepatic resection.

Materials and methods: Comparisons between 10 ultrasonic dissector group and 10 Kelly clamp crushing technique group were performed by using nine items (transaction time, right lobe volume, perioperative transfusion, total bilirubin (TB), aspartate aminotransferase (AST), alanine aminotransferase (ALT), hospital stay, postoperative morbidity, in-hospital mortality).

Results: The mean transection time in the Kelly clamp crushing technique group was 27+/-15.5 mins (range 15-60) and was 48+/-7.1 mins (range 35-60) in the ultrasonic dissector group (p<0.05), and no patients received transfusion in both groups.

Conclusions: Since the Kelly clamp crushing technique shortens operative time and there is no significant difference in blood loss and in results of liver function tests compared to using the ultrasonic dissector, we propose that the Kelly clamp crushing technique should be considered as a standard method of liver resection.

Keywords: Kelly clamp crushing technique; hepatocelluar carcinoma; ultrasonic dissector.

Figure 1.

Kelly clamp crushing technique along the demarcation line.

Figure 2.

Careful exposing of the middle hepatic vein.