Debakey Forceps Crushing Technique for Hepatic Parenchymal Transection in Liver Surgery: A Review of 100 Cases and Ergonomic Advantages release_zyfxxnwiw5epjhsnqrx53yzkg4

by Sundeep Jain, Bharat Sharma, Mitesh Kaushik, Lokendra Jain

Abstract

<jats:italic>Introduction and Objective</jats:italic>. Bleeding is an important complication in liver transections. To determine the safety and efficacy of Debakey forceps for liver parenchymal transection and its ergonomic advantages over clamp crushing method we analysed our data.<jats:italic>Methods</jats:italic>. We used Debakey crushing technique in 100 liver resections and analysed data for transection time, transfusion rate, morbidity, mortality, hospital stay, influence of different types of liver conditions, and ergonomi features of Debakey forceps.<jats:italic>Results</jats:italic>. Mean age, transection time and hospital stay of 100 patients were 52.38 ± 17.44 years, 63.36 ± 33.4 minutes, and 10.27 ± 5.7 days. Transection time, and hospital stay in patients with cirrhotic liver (130.4 ± 44.4 mins, 14.6 ± 5.5 days) and cholestatic liver (75.8 ± 19.7 mins, 16.5 ± 5.1 days) were significantly greater than in patients with normal liver (48.1 ± 20.1 mins, 6.7 ± 1.8 days) (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M1"><mml:mrow><mml:mi>P</mml:mi><mml:mo>&lt;</mml:mo><mml:mn>0.01</mml:mn></mml:mrow></mml:math>). Transection time improved significantly with experience (first fifty versus second fifty cases—70.2 ± 31.1 mins versus 56.5 ± 34.5 mins,<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M2"><mml:mrow><mml:mi>P</mml:mi><mml:mo>&lt;</mml:mo><mml:mn>0.04</mml:mn></mml:mrow></mml:math>). Qualitative evaluation revealed that Debakey forceps had ergonomic advantages over Kelly clamp.<jats:italic>Conclusions</jats:italic>. Debakey forceps crushing technique is safe and effective for liver parenchymal transection in all kinds of liver. Transection time improves with surgeon's experience. It has ergonomic advantages over Kelly clamp and is a better choice for liver transection.
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Published in HPB Surgery by Hindawi Limited
ISSN-L 0894-8569
Volume 2014
Page(s) 1-9
Release Year 2014
Publisher Hindawi Limited
Primary Language en (lookup)

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Type  article-journal
Stage   published
Year   2014
DOI  10.1155/2014/861829
PubMed  25009367
PMC  PMC4070417
Wikidata  Q38227836
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ISSN-L:  0894-8569
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