Spray Diathermy Versus Harmonic Scalpel Technique for Hepatic Parenchymal Transection

Study Overview
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Brief Summary
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Consecutive patients, who were treated for end stage liver cirrhosis by LDLT were included in this a prospective study.Patients enrolled in the study divided into two groups according to the day of surgery. The study population was divided into two groups; group (A) Parenchymal liver transection was performed by harmonic scalpel (HS) and group (B) Parenchymal liver transection was performed by spray diathermy (SD).

Detailed Description
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Consecutive patients, who were treated for end stage liver cirrhosis by LDLT were included in this a prospective study.Patients enrolled in the study divided into two groups according to the day of surgery. The study population was divided into two groups; group (A) Parenchymal liver transection was performed by harmonic scalpel (HS) and group (B) Parenchymal liver transection was performed by spray diathermy (SD). Donors and recipient were followed up after hospital discharge with laboratory investigation, abdominal ultrasound, MRCP in selected cases every month for the first month, then every 6 months and then every year postoperatively. Follow up visits included clinical examination, laboratory investigation, doses of immunosuppressive, radiological examination, and doppler US. The primary outcome was the amount of blood loss during transection. Secondary outcomes were operative time, time of transection, speed of transection/minutes , number of ligation used, degree of postoperative injury which assessed by daily liver function, WBC, C reactive protein, pathological changes at the cut surface, postoperative morbidity (including biliary leakage, collection), cost and hospital stay.

Official Title
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Spray Diathermy Versus Harmonic Scalpel Technique for Hepatic Parenchymal Transection of Living Donor.

Conditions
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End Stage Liver Disease

Intervention / Treatment
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* Device: harmonic scalpel
* Device: spray mode diathermy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Consecutive patients, who were treated for end stage liver cirrhosis by LDLT Exclusion Criteria: -

Ages Eligible for Study
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Minimum Age: 10 Years
Maximum Age: 50 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: harmonic scalpel<br>parenchymal liver transection was performed either by harmonic scalpel after demarcation of line of transection by intraoperative US and doppler. The clearly exposed vessels were ligated by 5/0 proline or clipped according to their size. | Device: harmonic scalpel<br>* parenchymal liver transection was performed either by harmonic scalpel after demarcation of line of transection by intraoperative US and doppler.<br>* Other names: Group A;|
| Active Comparator: spray mode diathermy<br>parenchymal liver transection was performed either by spray mode diathermy after demarcation of line of transection by intraoperative US and doppler. The clearly exposed vessels were ligated by 5/0 proline or clipped according to their size. | Device: spray mode diathermy<br>* parenchymal liver transection was performed either by spray mode diathermy after demarcation of line of transection by intraoperative US and doppler.<br>* Other names: Group B;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| the amount of blood loss | the amount of blood loss | 6 hours during operation | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| operative time |  | minutes during operations | 
| number of ligation used, |  | hours during operations | 
| extent of necrosis at the cut surface |  | one week postoperative | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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living donor liver transplantation