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Simplified Hepatic Resections With the Use of a Chang's Needle

Chang, Yu-Chung MD, PhD*; Nagasue, Naofumi MD, PhD; Chen, Chu-San MM; Lin, Xi-Zhang MD§

doi: 10.1097/01.sla.0000197380.33169.6e
Original Articles: Surgical Technique

Objective: To demonstrate the use of Chang's needle for hepatic resections.

Summary Background Data: Specialized instruments, fine surgical skills, and good control of hepatic inflow and backflow are essential for hepatic resections. This needle was specifically designed to simplify these requirements.

Methods: Whole-thickness interlocking sutures of the liver can first be made along the designed resection line with a Chang's needle; then parenchyma transection can follow without inflow or backflow control. This was consecutively performed on 69 patients with primary (41), metastatic (10), and benign (18) diseases since 1997.

Results: Blood loss during parenchyma transection was reduced in 11 right lobectomies (652 mL), 1 3-segmentectomy (300 mL), 14 bisegmentectomies (252 mL), 7 segmentectomies (104 mL), 12 subsegmentectomies (19 mL), 5 wedge resections (7 mL), 18 left lateral segmentectomies (110 mL), and 1 hepatorrhaphy (minimal). There was no procedure-related mortality. A mild bile leakage occurred in 1 case (1.5%) but healed spontaneously.

Conclusions: The preliminary results demonstrate that this maneuver is a simple, easy, and safe method for performing hepatic resections.

Chang's needle can simplify various kinds of hepatic resections. Blood loss was reduced with minimal procedure-related morbidity and mortality.

From the Departments of *Surgery, ‡Mechanic Engineering & Graduate Studies, and §Internal Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan; and †Second Department of Surgery, Shimane Medical University, Izumo, Japan.

Reprints: Yu-Chung Chang, MD, PhD, Department of Surgery, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, Tainan 70428, Taiwan. E-mail:

© 2006 Lippincott Williams & Wilkins, Inc.