Please select the eligibility criteria that correspond to the clinical trial below.
Title: Clamp-Crushing vs. Stapler Hepatectomy for Transection of the Parenchyma in Elective Hepatic Resection: CRUNSH - A Randomized Controlled Trial
Brief Summary: There is clinical uncertainty and ongoing discussion among liver surgeons regarding the optimal method of parenchymal transection in patients undergoing elective hepatic resection. While the clamp-crushing technique still represents the reference technique for routine liver resections, transection of liver parenchyma using vascular staplers may offer a new and safe technique potentially reducing intraoperative blood loss, operation time as well as peri-operative morbidity. As morbidity of patients undergoing hepatic resection remains high, approaches to lower peri-operative complications are urgently required. Due to the lack of evidence it has to be evaluated, if the technique of stapler hepatectomy decreases intraoperative blood loss as a highly relevant predictor of peri-operative complications, patients' hospital stay and finally health care expenditures. These advantages would favor stapler hepatectomy to be applied in routine liver resections. As RCTs are generally considered to generate the most valid scientific evidence on a treatment's effects, the present trial evaluates potential benefits of stapler hepatectomy in a randomized fashion.


Options:
A: 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
B: Inclusion Criteria:

* Patients scheduled for elective hepatic resection
* Stapler hepatectomy and clamp-crushing feasible based on preoperative imaging
* Age equal or greater than 18 years
* Informed consent

Exclusion Criteria:

* Participation in concurrent intervention trials
* Expected lack of compliance
* Impaired mental state or language problems
C: Inclusion Criteria:

* Subject is undergoing spinal surgery, hepatic resection, peripheral arterial bypass surgery, or arteriovenous graft formation for hemodialysis access

Exclusion Criteria:

* Subject has undergone a therapeutic surgical procedure within 30 days prior to surgery
* Subject has history of heparin-induced thrombocytopenia
* Subject has known antibodies or hypersensitivity to thrombin or other coagulation factors or known sensitivity to other components of the study treatment
* Subject has received blood products within 24 hours prior to surgery
D: Inclusion Criteria:

* Adults (18 years old or greater) who are able to provide informed consent.
* Patients who undergo an open, elective liver resection. Including those initially approached laparoscopically but converted to an open resection and those undergoing additional procedures.

Exclusion Criteria:

* Active coronary disease.
* Patients with a history of coronary disease will be eligible if they have had a cardiac stress study showing no reversible ischemia and normal LV function within 3 months of operation.
* Active symptomatic cerebrovascular disease.
* Active congestive heart failure and ejection fraction \<35%.
* Active severe restrictive or obstructive pulmonary disease and resting SpO2 \<90%.
* Active renal dysfunction (Cr \>1.8)
* Abnormal coagulation parameters (INR \> 1.8 not on Coumadin, or platelet count \< 100,000 per mcL)
* Presence of active infection including HIV
* Patients with active atrial fibrillation or flutter.
* Preoperative hypoalbuminemia (Albumin \< 2g/dl).
* Female patients who are pregnant (female patients of child-bearing potential must have a negative serum pregnancy test ≤ 14 days prior to surgery or 15 to 30 days prior to surgery with a negative urine pregnancy test the morning of surgery).
* Presence of ascites.
* BMI \> 45 or \<17

Answer: B