Usefulness of the Pinch-Burn-Cut (PBC) technique for recipient hepatectomy in liver transplantation

Abstract

Backgrounds/aims: Surgical bleeding during recipient hepatectomy is a major concern in liver transplantation (LT). Effective intraoperative control of bleeding is necessary. In the Pinch-Burn-Cut (PBC) technique, a small amount of tissue around the dissection plane is pinched with forceps, electocauterized and gently cut. The present study sought to estimate the usefulness of the PBC technique in LT.

Methods: Between June 2007 and December 2010, 123 adult cases underwent LT in our center. Of these, 72 involved a recipient hepatectomy using the PBC technique (PBC group). and 51 involved the conventional technique (non-PBC group). Clinical parameters were compared between two groups.

Results: The amount of blood loss and related transfusions were significantly reduced, and the operating time was shorter in the PBC group than in the non-PBC group (p=0.006, p<0.05 and p=0.002, respectively). There was also shorter duration of mechanical ventilation after LT in the PBC group (p=0.017). The incidence of postoperative hemorrhage was lower in the PBC group than in the non-PBC group, but had no statistical significance between two group (19.6% vs. 8.3%, p=0.101).

Conclusions: Our data suggest that the PBC technique is effective for bleeding control during recipient hepatectomy in LT.

Keywords: Hepatectomy; Liver transplantation; Surgical outcome.

Figures

Fig. 1. Dissection of the falciform ligament using Pinch-Burn-Cut (PBC) technique. Fine collateral vessels around the tip of the monopolar forcep were obliterated by PBC technique (arrow).