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Randomized clinical trial of stapler hepatectomy versus LigaSure™ transection in elective hepatic resection. BJS 2018; 105: 1119-1127.

Published: 11th July 2018

Authors: J. Fritzmann, J. Kirchberg, D. Sturm, A. B. Ulrich, P. Knebel, A. Mehrabi et al.


Previous studies have demonstrated stapler hepatectomy and use of various energy devices to be safe alternatives to the clamp‐crushing technique in elective hepatic resection. In this randomized trial, the effectiveness and safety of stapler hepatectomy were compared with those of parenchymal transection with the LigaSure™ vessel sealing system.


A total of 138 patients were analysed, 69 in the LigaSure™ and 69 in the stapler hepatectomy group. Baseline characteristics were well balanced between the groups. Mean intraoperative blood loss was significantly higher in the LigaSure™ group than the stapler hepatectomy group: 1101 (95 per cent c.i. 915 to 1287) versus 961 (752 to 1170) ml (P = 0·028). The parenchymal transection time was significantly shorter in the stapler group (P = 0·005), as was the total duration of operation (P = 0·027). Surgical morbidity did not differ between the groups, nor did the grade of complications.


Stapler hepatectomy was associated with reduced blood loss and a shorter duration of operation than the LigaSure™ device for parenchymal transection in elective partial hepatectomy. Registration number: NCT01858987 (http://www.clinicaltrials.gov).

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