High-intensity focused ultrasound (HIFU)-assisted hepatic resection in an animal model

Abstract

Background: Bleeding is the main cause of postoperative complications of hepatic surgery. To minimize intraoperative bleeding during hepatectomy, resections are generally carried out under hepatic vascular control despite the risk of liver dysfunction in patients with chronic liver disease. This study evaluates the feasibility and safety of high-intensity focused ultrasound (HIFU)-assisted hepatic resection during an open procedure in an animal model. Methods: Three groups of 12-14-week-old Landrace pigs (n = 7/group) were used to evaluate HIFU-assisted liver resection (group A) vs liver resection with or without portal triad clamping (groups B and C). In each pig, liver resection was performed on the right and left paramedian lobes. The following were evaluated and compared in the 3 groups: total blood loss, blood loss/cm2 of resection area, clip density, procedure duration, morbidity, and mortality. Results: Median blood loss was significantly lower in group A than in group B (P = .02), and group C (P = .007). Median blood loss/cm2 of resection area was 4.77 mL/cm2 in group A, 11.35 mL/cm2 in group B, 12.22 mL/cm2 in Group C. Precoagulation resulted in sealing blood vessels <5 mm; therefore, median clip density during liver transection was 0.78 clip/cm2 in group A, 1.61 clip/cm2 in group B, and 1.57 clip/cm2 in group C. Median duration of the surgical procedure was 12 min in group A, 21 min in group B, and 19 min in group C. Conclusions: HIFU-assisted hepatic resection during an open procedure in an animal model is safe, reduces bleeding, and allows real-time ultrasound guidance. © 2011 The Author(s).