• Andrea Muratore, Alfredo Mellano, Giuseppe Tarantino, Patrizia Marsanic, Michele De Simone, and Fabrizio Di Benedetto.
• Department of Surgical Oncology, Institute for Cancer Research and Treament (IRCC), Candiolo (TO), Italy.
• HPB (Oxford). 2014 Aug 1;16(8):707-12.

BackgroundLiver transection is considered a critical factor influencing intra-operative blood loss. A increase in the number of complex liver resections has determined a growing interest in new devices able to 'optimize' the liver transection. The aim of this randomized controlled study was to compare a radiofrequency vessel-sealing system with the 'gold-standard' clamp-crushing technique.MethodsFrom January to December 2012, 100 consecutive patients undergoing a liver resection were randomized to the radiofrequency vessel-sealing system (LF1212 group; N = 50) or to the clamp-crushing technique (Kelly group, N = 50).ResultsBackground characteristics of the two groups were similar. There were not significant differences between the two groups in terms of blood loss, transection time and transection speed. In spite of a not-significant larger transection area in the LF1212 group compared with the Kelly group (51.5 versus 39 cm(2) , P = 0.116), the overall and 'per cm(2) ' blood losses were similar whereas the transection speed was better (even if not significantly) in the LF1212 group compared with the Kelly group (1.1 cm(2) /min versus 0.8, P = 0.089). Mortality, morbidity and bile leak rates were similar in both groups.ConclusionsThe radiofrequency vessel-sealing system allows a quick and safe liver transection similar to the gold-standard clamp-crushing technique.© 2014 International Hepato-Pancreato-Biliary Association.

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