To investigate the application value of precise Kelly forceps clamping method in hepatectomy.

Clinical data of 45 patients who received liver resection in Department of Hepatobiliary Surgery, the First Affiliated Hospital of Kunming Medical University from January 2010 to October 2012 were analyzed retrospectively. The patients were divided into 2 groups according to the surgical procedures of liver resection: one group of hepatectomy using precise Kelly forceps clamping(precise hepatectomy group) and the other group of hepatectomy using traditional method (traditional hepatectomy group). There were 30 patients in precise hepatectomy group(14 males and 16 females; the median age of 45 years old, range 25-67 years old). There were 15 patients in traditional hepatectomy group(6 males and 9 females; the median age of 42 years old, range 30-64 years old). The informed consents of all patients were obtained and the ethical committee approval was received. In precise hepatectomy group, the liver tissues were crushed with Kelly forceps in a small range. The crushing range was controlled within 1 cm every time. The intrahepatic streak vessels were exposed and sutured with small right-angle clamps or prolene threads, except for the extremely tiny ones which were cut off by electrocoagulation. For the patients in traditional hepatectomy group, liver resection was performed by using mass tissue clamping and transfixion. Measurement data between two groups was compared by t test or U test. The incidence of perioperative complications between two groups was compared by Chi-square test.

All the operations were successful. The median volume of intraoperative bleeding in precise hepatectomy group was 350(50-800)ml, which was evidently less than that in traditional hepatectomy group [625(50-1400)ml] and significant difference was observed (U=6.23, P<0.05) . No significant difference was observed in the operation duration between precise hepatectomy group and traditional hepatectomy group [ (254±97) min vs. (236±75) min; t=3.21, P>0.05]. The postoperative length of hospital stay in precise hepatectomy group was evidently less than that in traditional hepatectomy group, and there was significant difference between two groups [(9.2±0.8)d vs. (13.9±3.8)d; t=2.27, P<0.05]. No death was observed during the perioperative period in both groups. No liver cross section bleeding, bile leakage, peritoneal infection occurred in patients in precise hepatectomy group after operation but 5 cases of pleural effusion that were cured by thoracentesis or conservative treatment. In traditional hepatectomy group, 3 patients suffered from bile leakage and were cured by peritoneal drainage or symptomatic treatment. Four cases suffered from pleural effusion and were cured by thoracentesis. One case suffered from pulmonary infection and was cured by anti-infection treatment. The incidence of complications in precise hepatectomy group was evidently lower than that in traditional hepatectomy group [17% (5/30) vs. 53% (8/15) ; χ²= 5.75, P<0.05].

Precise Kelly forceps clamping method in hepatectomy has the advantages of simple requirement of equipment, clear anatomy, low incidence of postoperative complications, which has a certain clinical application value in hepatic surgery.