Concerns About Ultrasound-Guided Radiofrequency-Assisted Segmental Liver Resection

Liver resection is still associated with 3 significant problems: blood loss, bile leak, and local recurrence at the resection margin following R0 resection. We compared the results of the Torzilli and Makuuchi groups using the crush clamping liver resection technique versus liver resection using Habib 4X coagulation and scalpel transection (Table 1, online only, Supplemental Digital Content 1, available at: http://links.lww.com/SLA/A47).1–6 Of course, it is difficult to make a direct comparison due to the different case mix and the lack of a randomized clinical trial. However, the results show less blood loss, a reduced blood transfusion requirement, and fewer incidences of bile leak with the Habib 4X technique. Wagman et al1 have reported 5% local recurrence at the resection margin in 76 liver resections, which is in keeping with our results of 4.8% in 208 R0 resections (Pai et al, unpublished data 2009).