Surgical Endoscopy

, Volume 32, Issue 5, pp 2454–2465 | Cite as

LigaSure versus CUSA for parenchymal transection during laparoscopic hepatectomy in hepatocellular carcinoma patients with cirrhosis: a propensity score-matched analysis

Article

Abstract

Background

LigaSure has been reported as a safe and effective approach for parenchymal transection in open hepatectomy; however, its roles in laparoscopic hepatectomy (LH) with liver cirrhosis have not been evaluated. The aim of this study was to compare the outcomes of LigaSure vs. Cavitron Ultrasonic Surgical Aspirator (CUSA) for LH in hepatocellular carcinoma (HCC) patients with cirrhosis.

Methods

We retrospectively reviewed the medical records of 135 HCC patients with background cirrhosis who underwent pure LH using CUSA (n = 55) or LigaSure (n = 80) for parenchymal transection between January 2015 and May 2017 at West China Hospital of Sichuan University. We performed 1:1 propensity score matching between the LigaSure and CUSA groups. Subsequently, 48 patients were included in each group.

Results

The mean parenchymal transection time (74.3 ± 23.6 vs. 86.3 ± 25.8 min, P = 0.019) in the LigaSure group was obviously shorter than that in the CUSA group. The LigaSure did not increase the intraoperative blood loss or blood transfusion requirement when compared with CUSA. Moreover, the degree of postoperative reperfusion injury and complications were not significantly different between the two groups. Furthermore, there were no significant differences between the two groups regarding 2-year overall survival rate or disease-free survival rate. In addition, the total hospitalization costs (P = 0.032) and intraoperative costs (P = 0.006) per case were significantly lower in the LigaSure group than those in the CUSA group.

Conclusion

The two devices were safe and effective for LH in patients with cirrhosis. The LigaSure method may be a simple, feasible, and cost-effective surgical technique for LH in selected HCC patients with cirrhosis.

Keywords

Laparoscopic hepatectomy LigaSure Cavitron Ultrasonic Surgical Aspirator Hepatocellular Carcinoma Cirrhosis 

Notes

Acknowledgements

This work was supported by the National Natural Science Foundation of China (No. 81602910) and the Fundamental Research Fund for the Central Universities (No. 2017SCU11045).

Compliance with ethical standards

Disclosures

Drs. Fei Liu, YongGang Wei, HongYu Li, WenTao Wang, TianFu Wen, Hong Wu, JiaYin Yang, MingQing Xu, and Bo Li have no conflict of interest or financial ties to disclose.

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Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  • Fei Liu
    • 1
  • YongGang Wei
    • 1
  • HongYu Li
    • 2
  • WenTao Wang
    • 1
  • TianFu Wen
    • 1
  • Hong Wu
    • 1
  • JiaYin Yang
    • 1
  • MingQing Xu
    • 1
  • Bo Li
    • 1
  1. 1.Department of Liver Surgery & Liver Transplantation Center, West China HospitalSichuan UniversityChengduChina
  2. 2.Department of Pancreatic Surgery, West China HospitalSichuan UniversityChengduChina

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