Randomized Comparative Study between Using Harmonic Scalpel versus Cavitron Ultrasonic Surgical Aspirator with Bipolar Cautery in Living Donor Hepatectomy for Living Donor Liver Transplantation

Document Type : Original Article

Authors

1 General Surgery Specialist, Nasser Institute of Health and Research, Egypt

2 Associate Professor of General Surgery, Faculty of Medicine, Ain Shams University, Egypt

3 Professor of General Surgery, Faculty of Medicine, Ain Shams University, Egypt

4 .Professor of General Surgery, Faculty of Medicine, Ain Shams University, Egypt

5 ..Professor of General Surgery, Faculty of Medicine, Ain Shams University, Egypt

Abstract

Background: Liver donation is a respectable human gift. It is essential that complications should be minimized as
much as possible and must be safely performed.
Aim of the work: To evaluate feasibility and safety of using CUSA for liver resection in living donor liver
transplantation (LDLT) in comparison with harmonic scalpel.
Patients and methods: This prospective study included 40 consecutive donors for LDLT held at Nasser Institute
and Air Force Specialized Hospital during the period from September 2017 to September 2018.
Results: Harmonic scalpel significantly reduced operative time (p=0.000) with a reduced blood loss (p=0.016),
however it caused higher rate of biliary leakage (40% vs 15% respectively). On the other hand, CUSA showed
lower bile leak leading to shorter hospital stay (p=0.000).
Conclusion: Although harmonic scalpel is a faster method, CUSA is more effective and safer with a lower
complication rate despite being cumbersome and need a longer learning curve.

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