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- Jersenius, U., et al.
(författare)
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Laparoscopic parenchymal division of the liver in a porcine model : comparison of the efficacy and safety of three different techniques
- 2007
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Ingår i: Surgical Endoscopy. - : Springer Science and Business Media LLC. - 0930-2794 .- 1432-2218. ; 21:2, s. 315-320
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Bleeding is a known and CO2 embolization a suggested risk factor for increased morbidity after laparoscopic liver resection. Devices for laparoscopic liver parenchymal transection must be evaluated for safety in this context. METHOD: Twelve piglets underwent laparoscopic surgery during CO2 pneumoperitoneum, each animal receiving three 6 cm long transections into the liver parenchyma made with ultrasonic dissector, ultrasonic shears and vessel sealing system, respectively. Endpoints were bleeding, operation time and gas embolization. The transections and embolization events, evaluated with transesophageal echocardiography, were video recorded. Bleeding and embolization were also assessed on video tapes and operating time measured. Arterial blood gases were recorded on line. RESULTS: The ultrasonic dissector was least advantageous in terms of bleeding and operation time. Gas embolization was more frequent with the vessel sealing system than with the ultrasonic dissector and ultrasonic shears. During two episodes of gas embolization, pCO2 increased and pO2 and pH decreased. CONCLUSIONS: Use of all three devices is feasible. Bleeding and operation time are greatest with the ultrasonic dissector. Gas embolization occurs during transection, though in most instances it is completely harmless. Laparoscopic liver surgery with these techniques used may pose a risk of gas embolization with clinical implications. Monitoring for such events is probably to be recommended.
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- Jersenius, U, et al.
(författare)
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Liver operations in Sweden in 1987-99
- 2005
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Ingår i: Scandinavian journal of surgery : SJS : official organ for the Finnish Surgical Society and the Scandinavian Surgical Society. - : SAGE Publications. - 1457-4969. ; 94:1, s. 25-30
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Tidskriftsartikel (refereegranskat)abstract
- Liver surgery is developing with new techniques and treatment modalities. The aim of this study is to describe liver surgery over a long period of time in a country with a public health care system. Patients and Method: A register study including adult patients admitted for liver resection in Sweden (population 8.8 million) selected from the Inpatient Register 1987–99. Additional data were collected from the Swedish Cancer Register and the Cause of Death Register. Analyses of the patients, indications, mortality and causes of death are presented. Results: 2,405 operations were performed (21 per million per year). The most frequent indication was colorectal metastases (27 %). The 5-year survival after an operation for primary liver cancer and colorectal liver metastases was 27 % and 26 %, respectively. Conclusions: Few patients were admitted for liver operations compared to expected figures. The survival rates are in conformity with those previously published. With an increasing awareness of the relatively favourable prognosis and the introduction of new methods, the volume of liver operations will probably increase in Sweden.
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