Effective vascular endostapler techniques in hepatic resection

The purpose of this report is to describe the technique of liver resection using an endovascular stapling device. A total of 31 patients underwent maj or hepatic resections with stapling techniques. The authors have used vario us approaches to portal structures and hepatic veins with the application o f a vascular endostapler device. The specific techniques of different hepat ectomies are described and illustrated. There were no deaths. A minor complication (biliary fistula) occurred in on e patient, related to binary leak from parenchymal transection. No complica tions directly attributable to stapler ligations of portal pedicle or hepat ic veins were observed. Stapling techniques can be helpful in major hepatic resection procedures. The vascular endostapler can significantly reduce bo th portal vein and hepatic vein closure time and may expedite the transecti on of the liver, eliminating the risk of slipped ligature following simple ligation.