Comparison of application of three ligation methods in pericardial devascularization

doi:10.3877/cma.j.issn.2095-3232.2021.06.014

Abstract

Abstract:

Objective

To compare the application of three ligation methods traditional silk thread, Hem-o-lok clip and Endo-GIA in pericardial devascularization.

Methods

Clinical data of 60 patientswith liver cirrhosis and portal hypertension who underwent pericardial devascularization in Shanghai Sixth People's Hospital Affiliated to Shanghai Jiaotong University from January 2016 to January 2019 were retrospectively analyzed. Among them, 23 patients were male and 37 female, aged from 35 to 65 years, with a median age of 50 years. The informed consents of all patients were obtained and the local ethical committee approval was received. According to different ligation methods used in the operation, all patients were divided into the silk thread group (n=32), Hem-o-lok (HL) group (n=10), and Endo-GIA (EG) group (n=18). Perioperative conditions and incidence of postoperative complications were statistically compared among three groups. The operation time, intraoperative blood loss and length of postoperative hospital stay were compared among three groups by using one-way ANOVA. Comparison between 2 groups was performed by LSD-t test. The incidence of postoperative complications was compared by Chi-square test.

Results

The average operation time in the silk thread group was (155±33) min, (144±21) min in the HL group and (120±30) min in the EG group, where significant differences were observed (F=6.153, P<0.05). The intraoperative blood loss in the silk thread group was (242±27) ml, (169±15) ml in the HL group and (119±16) ml in the EG group, where significant differences were observed (F=8.574, P<0.05). In the silk thread group, the length of postoperative hospital stay was (12.2±2.6) d, (10.8±2.4) d in the HL group and (9.3±2.4) d in the EG group, where significant differences were observed (F=4.158, P<0.05). In the silk thread group, 7 patients developed postoperative complications, and 2 cases in the HL group and 3 cases in the EG group, where no significant difference was observed (χ²=0.25, P=0.87).

Conclusions

Hem-o-lok clip, Endo-GIA or traditional silk thread ligation techniques are safe in pericardial devascularization, whereas Hem-o-lok clip and Endo-GIA have advantages in shortening operation time, reducing intraoperative blood loss and shortening the length of postoperative hospital stay.

Key words: Liver cirrhosis, Hypertension, portal, Pericardial devascularization

Shigeng Chen, Mingjun Liang, Jiao Guan, Zunqiang Zhou, Guangwen Zhou. Comparison of application of three ligation methods in pericardial devascularization[J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2021, 10(06): 599-603.

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References 19

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组别	例数	性别（例）		年龄（岁，±s）	BMI（kg/m²，±s）	Child-Pugh分级（例）		病因（例）				Plt（×10⁹/L，±s）
组别	例数	男	女	年龄（岁，±s）	BMI（kg/m²，±s）	A	B	HBV肝硬化	HCV肝硬化	自身免疫性肝炎	血吸虫病肝硬化	Plt（×10⁹/L，±s）
丝线组	32	11	21	53±12	23.4±3.8	9	23	25	5	1	1	43.0±5.7
HL组	10	5	5	49±10	22.9±2.7	3	7	7	3	0	0	57.0±2.3
EG组	18	7	11	47±12	21.2±3.3	7	11	14	3	1	0	49.0±4.1
统计值		χ²=0.123		F=1.136	F=0.678	χ²=0.537		-				F=2.343
P值		0.896		0.356	0.468	0.686		0.897				0.135

组别	例数	性别（例）		年龄（岁，±s）	BMI（kg/m²，±s）	Child-Pugh分级（例）		病因（例）				Plt（×10⁹/L，±s）
组别	例数	男	女	年龄（岁，±s）	BMI（kg/m²，±s）	A	B	HBV肝硬化	HCV肝硬化	自身免疫性肝炎	血吸虫病肝硬化	Plt（×10⁹/L，±s）
丝线组	32	11	21	53±12	23.4±3.8	9	23	25	5	1	1	43.0±5.7
HL组	10	5	5	49±10	22.9±2.7	3	7	7	3	0	0	57.0±2.3
EG组	18	7	11	47±12	21.2±3.3	7	11	14	3	1	0	49.0±4.1
统计值		χ²=0.123		F=1.136	F=0.678	χ²=0.537		-				F=2.343
P值		0.896		0.356	0.468	0.686		0.897				0.135

组别	例数	手术时间（min)	术中出血量（ml）	术后住院时间（d）
丝线组	32	155±33	242±27	12.2±2.6
HL组	10	144±21^a	169±15^a	10.8±2.4^a
EG组	18	120±30^b	119±16^b	9.3±2.4^b
F值		6.153	8.574	4.158
P值		<0.001	<0.001	0.008

组别	例数	手术时间（min)	术中出血量（ml）	术后住院时间（d）
丝线组	32	155±33	242±27	12.2±2.6
HL组	10	144±21^a	169±15^a	10.8±2.4^a
EG组	18	120±30^b	119±16^b	9.3±2.4^b
F值		6.153	8.574	4.158
P值		<0.001	<0.001	0.008

组别	例数	出血	胸腹腔积液	膈下脓肿	胰漏
丝线组	32	1	4	0	2
HL组	10	0	0	1	1
EG组	18	0	3	0	0

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