Hepatectomy using a bipolar vessel-sealing scalpel with Takasaki’s Glissonean pedicle transection method in hepatocellular carcinoma: A singlecentre short-term outcome

Abstract

Purpose: The study aimed to evaluate the results of a bipolar vessel-sealing (LigaSure™) scalpel application for parenchymal resection combined with Glissonean pedicle transection using the Takasaki method in the treatment of hepatocellular carcinoma (HCC). Patients and methods: A prospective descriptive study was performed on 67 patients from August 2021 to April 2022 (6 months). Results: The mean age was 56±12 years (14-76). Durations for right and left Glisson pedicle control were 3.44±1.65 and 4.58±4.05 minutes, respectively, while those for anterior and posterior pedicle control were 6.12±4.05 and 6.08±3.79 minutes, respectively. The mean blood loss during pedicle control was 21.88±14.02 ml; there were no complications during pedicle transection. The average time of parenchymal resection was 33.96±12.32 minutes, the average intraoperative blood loss was 211.79±125.41 ml, and there was one patient requiring intraoperative blood transfusion. All 3 cases of intraoperative complications were hepatic vein laceration. The overall rate of postoperative complications was 2.98%, of which postoperative liver failure accounted for 1.49%. The average number of days in hospital postoperatively was 8 days, the shortest was 6 days and the longest was 15 days. The rate of in-hospital mortality was 0%. Conclusion: The bipolar vessel-sealing (LigaSure™) scalpel application for parenchymal resection combined with Glissonean pedicle transection using the Takasaki method in the treatment of HCC is safe and effective.