Perioperative outcome of laparoscopic left lateral liver resection is improved by using a bioabsorbable staple line reinforcement material in a porcine model. Academic Article Article uri icon

Overview

MeSH

  • Animals
  • Bile
  • Bile Ducts
  • Female
  • Intraoperative Complications
  • Intraoperative Period
  • Liver
  • Models, Animal
  • Polymers
  • Postoperative Complications
  • Prospective Studies
  • Survival Analysis
  • Swine
  • Treatment Outcome

MeSH Major

  • Absorbable Implants
  • Hepatectomy
  • Laparoscopy
  • Surgical Mesh
  • Surgical Stapling

abstract

  • Laparoscopic liver surgery is significantly limited by the technical difficulty encountered during transection of substantial liver parenchyma, with intraoperative bleeding and bile leaks. This study tested whether the use of a bioabsorble staple line reinforcement material would improve outcome during stapled laparoscopic left lateral liver resection in a porcine model. A total of 20 female pigs underwent stapled laparoscopic left lateral liver resection. In group A (n = 10), the stapling devices were buttressed with a bioabsorbable staple line reinforcement material. In group B (n = 10), standard laparoscopic staplers were used. Operative data and perioperative complications were recorded. Necropsy studies and histopathological analysis were performed at 6 weeks. Data were compared between groups with the Student's t-test or the chi-square test. Operating time was similar in the two groups (64 +/- 11 min in group A versus 68 +/- 9 min in group B, p = ns). Intraoperative blood loss was significantly higher in group B (185 +/- 9 mL versus 25 +/- 5 mL, p < 0.05). There was no mortality. There was no morbidity in the 6-week follow-up period; however, two animals in group B had subphrenic bilomas (20%) at necropsy. At necropsy, methylene blue injection via the main bile duct revealed leakage from the biliary tree in four animals in group B and none in group A (p < 0.05). Histopathological examination of the resection site revealed minor abnormalities in group A while animals in group B demonstrated marked fibrotic changes and damaged vascular and biliary endothelium. Use of a bioabsorbable staple line reinforcement material reduces intraoperative bleeding and perioperative bile leaks during stapled laparoscopic left lateral liver resection in a porcine model.

publication date

  • May 2008

has subject area

  • Absorbable Implants
  • Animals
  • Bile
  • Bile Ducts
  • Female
  • Hepatectomy
  • Intraoperative Complications
  • Intraoperative Period
  • Laparoscopy
  • Liver
  • Models, Animal
  • Polymers
  • Postoperative Complications
  • Prospective Studies
  • Surgical Mesh
  • Surgical Stapling
  • Survival Analysis
  • Swine
  • Treatment Outcome

Research

keywords

  • Comparative Study
  • Journal Article

Identity

Language

  • eng

PubMed Central ID

  • PMC2358937

Digital Object Identifier (DOI)

  • 10.1007/s00464-007-9718-6

PubMed ID

  • 18246395

Additional Document Info

start page

  • 1188

end page

  • 1193

volume

  • 22

number

  • 5