Usefulness of BiClamp Forceps for Liver Resection: A Randomized Clinical Trial
BiClamp Forceps Liver Transection Versus Clamp Crushing Technique in Liver Resections: A Randomized Clinical Trial
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Background: Blood loss and the need for blood transfusions during the liver transection have shown to be correlated with higher morbidity and mortality rates and with worsen prognosis. Various devices of liver parenchymal transection have been developed with a view to reducing the intraoperative blood loss. However, to the present there is no randomized controlled trial evaluating the technique of BiClamp forceps during the liver transection. The goal of the present study was to evaluate the safety and effectiveness of BiClamp forceps transection in comparison to the clamp crushing technique in patients offered liver resection.
Intervention: One hundred patients with hepatobiliary disease need undergo hepatectomy at Anhui medical university were selected and divided into BiClamp forceps hepatectomy group and clamp-crushing hepatectomy group, each group contains 50 cases.
Results:
- Clinical data include: blood loss during liver transection, total blood loss, blood transfusion, hospital stay, morbidity, mortality, biliary leakage, postoperative liver function, liver transection time, operation time, resection margins, need for portal trial clamping.
- Statistical method: groups t-test, univariate/multivariate analysis, logistic regression analysis, mixed linear regression and Cox survival analysis were used.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 3
Contacts and Locations
Study Locations
-
-
Anhui
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Hefei, Anhui, China, 230022
- The Second Affiliated Hospital of Anhui Medical University
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Both male and female, aged 18 or older
- Patients scheduled to undergo hepatic resection for some benign or malignant hepatobiliary disease
- Child-Pugh class A or B liver function
- BiClamp forceps hepatectomy and clamp-crushing feasible based on preoperative imaging
- No tumor invasion the main vein, hepatic artery and vein and major inferior vena cava
- No extrahepatic metastasis
- Voluntary participation in the study, and informed consent.
Exclusion Criteria:
- Age <18 years or> 65 years , pregnant or lactating women
- Preoperative liver function evaluation: Child-Pugh C grade
- Laparoscopic hepatectomy
- Extrahepatic metastasis
- Tumor invasion the main vein, hepatic artery and vein and major inferior vena cava
- The patient refused to sign the informed consent form
Study Plan
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: NONE
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
ACTIVE_COMPARATOR: Clamp-Crushing technique
liver transection during hepatectomy by the routine clamp-crushing technical without BiClamp forceps assisted
|
Liver transection during hepatectomy by monopole electronicknife and blood vessel forceps, but without BiClamp forceps
|
|
EXPERIMENTAL: BiClamp forceps hepatectomy
The BiClamp forceps, a reusable bipolar sealing instrument for use in open surgery, was uniformly employed in all patients randomized to BiClamp forcep hepatectomy group in the present study.
|
liver transection during hepatectomy by BiClamp forceps
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
The Total Blood Loss
Time Frame: an expected average of 80 minutes
|
Blood loss during operation.
Blood loss was calculated from the beginning to the end of operation The amount of blood loss was measured from the suction volume after subtraction of rinse fluids and from the weight of soaked gauzes that were used during transection
|
an expected average of 80 minutes
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Morbidity
Time Frame: 90 days
|
90 days
|
|
|
Mortality
Time Frame: 90 days
|
Operative mortality was defined as any death resulting from a complication during surgery
|
90 days
|
|
Liver Transection Time
Time Frame: an expected average of 40 minutes
|
liver transection time was calculated from the beginning to the end of the liver resection
|
an expected average of 40 minutes
|
|
Biliary Leakage
Time Frame: 90 days
|
Biliary leakage was documented in line with the International Study Group of Liver Surgery (ISGLS) definitions and grading systems
|
90 days
|
|
Duration of Postoperative Hospital Stay
Time Frame: an expected average of 12 days
|
Time from day of operation to day of discharge
|
an expected average of 12 days
|
|
Number of Participants Requiring a Blood Transfusion
Time Frame: 2 days
|
Administration of blood transfusions is documented for the intraoperative and postoperative period until 48 hours postoperatively
|
2 days
|
|
Total Bilirubin
Time Frame: 3 postoperative day
|
serum total bilirubin on 3 postoperative day (umol/L)
|
3 postoperative day
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Geng Xiaoping, The second hospital of Anhui medical university
Publications and helpful links
General Publications
- Kooby DA, Stockman J, Ben-Porat L, Gonen M, Jarnagin WR, Dematteo RP, Tuorto S, Wuest D, Blumgart LH, Fong Y. Influence of transfusions on perioperative and long-term outcome in patients following hepatic resection for colorectal metastases. Ann Surg. 2003 Jun;237(6):860-9; discussion 869-70. doi: 10.1097/01.SLA.0000072371.95588.DA.
- Gurusamy KS, Pamecha V, Sharma D, Davidson BR. Techniques for liver parenchymal transection in liver resection. Cochrane Database Syst Rev. 2009 Jan 21;(1):CD006880. doi: 10.1002/14651858.CD006880.pub2.
- Itoh S, Fukuzawa K, Shitomi Y, Okamoto M, Kinoshita T, Taketomi A, Shirabe K, Wakasugi K, Maehara Y. Impact of the VIO system in hepatic resection for patients with hepatocellular carcinoma. Surg Today. 2012 Dec;42(12):1176-82. doi: 10.1007/s00595-012-0306-6. Epub 2012 Sep 20.
- Chen JM, Geng W, Liu FB, Zhao HC, Xie SX, Hou H, Zhao YJ, Wang GB, Geng XP. BiClamp(R) forcep liver transection versus clamp crushing technique for liver resection: study protocol for a randomized controlled trial. Trials. 2015 Apr 30;16:201. doi: 10.1186/s13063-015-0722-1.
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (ACTUAL)
Primary Completion
Study Completion (ACTUAL)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (ESTIMATE)
First Posted
Study Record Updates
Last Update Posted (ACTUAL)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- ahykdxdefsyy10
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Study Data/Documents
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Study Protocol
Information identifier: PMID:25925431
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