Ultrasonicknife,Liga Sure,LPMOD Research In Clinical Effect Of Laparoscopic Hepatectomy

Objective: to compare the ultrasonic knife, LigaSure, LPMOD research in clinical effect of laparoscopic hepatectomy, analyzed the advantages and disadvantages of three kinds of instruments, choose the best cutting for laparoscopic liver resection liver devices.Methods:retrospective analysis between December 2011 and December 2011, the second affiliated hospital of kunming medical university courage pancreas surgery treated has Laparoscopic liver resection (Laparoscopic hepatectomy, LH) in patients with clinical data.52 cases of male,38 cases of female. Age from 25 to 78 years old, average (52.1-13.2).49 patients (54.4%) has a history of hepatitis or liver cirrhosis, liver disease. According to the cut way of liver is divided into three groups: group A: ultrasonic knife (Ultracision harmonic scalpel, UHS) group of 30 cases. Group B: ligation of blood vessels (LigaSure) group of 30 cases of closed system. Group C: Laparoscopic ajay multi-function dissector (Laparoscopic surgery Peng’s multifunctional operation dissector, LPMOD) group of 30 cases. Compare three groups of preoperative general situation and preoperative liver function, blood coagulation function and liver cutting range, intraoperative blood loss, blocking porta time, operation time, postoperative liver function and liver function recovery time, albumin, and albumin recovery time, recovery time of white blood cells and white blood cells, body temperature and body temperature recovery time, bilirubin, length of hospital stay, live in SICU days days, hospitalization expenses and abdominal cavity drainage, gastrointestinal function recovery time and postoperative complications, and so on.Results:preoperative: general situation of three groups of patients, the infection rate of hepatitis b, liver function, Child grading, albumin, total bilirubin, and prothrombin time, Alt, aspertate aminotransferase, international standardization ratio are not (p> 0.05). Intraoperative:operation time, blocking hepatic door there is significant difference between the three groups (p< 0.05), with statistical significance. Two comparison showed that the group A and group B in the aspect of operation time, blocking porta time difference significant (p< 0.05), with statistical significance. Group A and group C has significant difference in operative time (p< 0.05), with statistical significance. Group A and group C in blocking porta time there was no significant difference (p> 0.05), no statistical significance. Group B and C group there was no significant difference in operative time (p> 0.05), no statistical significance. Group B and C group have significant difference in terms of blocking porta time (p< 0.05), with statistical significance. Three groups in terms of intraoperative blood loss, there was no significant difference (p> 0.05), no statistical significance. Surgery: A, B, C three groups of albumin after surgery, postoperative white blood cells, white blood cells recovery time after operation, postoperative body temperature and postoperative recovery time, hospitalization expenses, live in SICU days after operation, postoperative hospitalization days, gastrointestinal function recovery time and abdominal cavity drainage days there was no significant difference (p>0.05), no statistical significance. A, B, C three groups of cereal third transaminase, cereal third transaminase recovery time after surgery, postoperative aspertate aminotransferase, aspertate aminotransferase recovery time, postoperative bilirubin and postoperative prothrombin time difference significant (p<0.05), with statistical significance. Specific pairwise comparison, group A and group B cereal third transaminase, cereal third transaminase recovery time after surgery, postoperative aspertate aminotransferase, aspertate aminotransferase recovery time and postoperative bilirubin and postoperative prothrombin time difference significant (p<0.05), with statistical significance. Group A and group C cereal third transaminase, cereal third transaminase recovery time after surgery, postoperative aspertate aminotransferase, aspertate aminotransferase recovery time and postoperative bilirubin, and prothrombin time postoperative etc. There was no significant difference (p>0.05), no statistical significance. Group B and group C cereal third transaminase, cereal third transaminase recovery time after surgery, postoperative aspertate aminotransferase, aspertate aminotransferase recovery time, postoperative bilirubin and postoperative prothrombin time difference significant (p< 0.05), with statistical significance. In terms of postoperative complications, A, B, C three groups in terms of abdominal bleeding, abdominal cavity infection, pulmonary infection there was no significant difference (p> 0.05), no statistical significance. A, B, C three groups have significant difference in the aspect of bile leakage (p< 0.05), with statistical significance. Specific two comparison, group A and group B had significant difference in the aspect of bile leakage (p< 0.05), with statistical significance. Group A and group C has significant difference in the aspect of bile leakage (p< 0.05), with statistical significance. Group B and C group there was no significant difference in the aspect of bile leakage (p> 0.05), no statistical significance.conclusion1, master the laparoscopic liver cutting methods of dealing with the difficulties of bleeding and liver section, laparoscopic application ultrasonic knife, LigaSure, LPMOD liver resection is safe and feasible, is worth popularizing in clinic.2, ultrasonic knife, LigaSure, LPMOD three liver cutting tools have their respective advantages and limitations.