Routine anterior approach during right hepatectomy: results of a prospective randomised controlled trial.

Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract
L CapussottiLuca Viganò

Abstract

A prospective randomised controlled trial was designed to evaluate the advantages of routine application of the anterior approach during right hepatectomy. The study was conducted between March 2005 and April 2009 in a tertiary hepatobiliary-pancreatic centre. Patients scheduled for right hepatectomy for primary or metastatic tumours, without infiltration of segment 1, inferior vena cava or main bile duct, were randomly assigned to right hepatectomy using either an anterior or a classic approach. The primary study endpoint was overall blood loss. Sixty-six patients were randomly allocated to undergo right hepatectomy with an anterior (AA group n=33) or a classic approach (CA group n=33). Sixty-five patients were included in the analysis (33 in AA group and 32 in CA group). There was no significant difference in patient age, diagnosis, preoperative hepatic biochemistry and tumour size between the two groups. Overall blood loss (437 ml ± 664 in AA group vs.500 ml ± 532.3 in CA group; p=0.960) and bleeding during transection (p=0.973) were similar between two groups. Perioperative blood transfusion rates were 18% in the AA group and 9.3 % in the CA group (p=0.253). Time of parenchymal transsection was significantly longer in AA gr...Continue Reading

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Citations

Apr 30, 2016·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Liuxin CaiXiujun Cai
Nov 2, 2016·The Cochrane Database of Systematic Reviews·Elisabetta MoggiaKurinchi Selvan Gurusamy
Dec 3, 2014·World Journal of Surgery·Jin Hong LimJin Sub Choi
Dec 11, 2014·World Journal of Gastroenterology : WJG·Lei LiJia-Yin Yang

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