Background: The first retrospective studies were performed to compare the e
fficacy of the ultrasonic cavitational aspirator (aspirator group) and the
ultrasonically activated scalpel (scalpel group) for hepatic resection in p
atients with hepatocellular carcinoma. Patients and Methods: The aspirator
group consisted of 8 patients (6 with liver cirrhosis and 2 with chronic he
patitis in the nontumorous liver), and the scalpel group of 7 patients (6 w
ith liver cirrhosis and 1 with chronic hepatitis). All patients underwent l
imited hepatic resection, and the intermittent Pringle maneuver was applied
during hepatic transection. Results: There were no significant differences
in preoperative hepatic function, type of hepatectomy, tumor size and maxi
mum cross-sectional area of the resected specimen between the 2 groups. The
amount of intraoperative blood loss was significantly less in the scalpel
group than in the aspirator group (684 versus 1,859 mi, p < 0.05). The oper
ation time was significanly shorter in the scalpel group than in the aspira
tor group (176 versus 262 min, p < 0.05). There were no significant differe
nces in postoperative liver function and morbidity between the 2 groups. Co
nclusions: The ultrasonically activated scalpel is effective in reducing bl
ood loss and in shortening the time of operation, and can be employed durin
g limited resection of the liver with cirrhosis or chronic hepatitis. Copyr
ight (C) 2900 S. Karger AG. Basel.