Background:
Radiofrequency (RF) assisted hepatectomy minimizes perioperative blood loss. Contemporary techniques used are the sequential-coagulate-cut (SCC) technique and the one using the Habib 4X bipolar electrode. Animal studies have shown that liver RF ablation induces mild injury to remnant liver tissue. We sought to study remnant liver tissue injury after each technique.

Material and Methods:
Sixteen pigs were assigned to 4 groups; resection of part of the left lateral and left median lobes using the SCC technique (group SCC), the Habib 4X electrode (group H) or the “crash-clamp” technique (group CC), and sham operation (group Sham). Liver tissue samples were excised at 48 hours from the right lateral lobe for histological and immunohistochemical assessment of tissue injury.

Result:
The histopathologic score was increased in groups SCC (mean, 4.1±0.7) and CC (4.4±1.3) but not in group H (1.5±0.9). The apoptotic index was increased in all study groups being more pronounced in group SCC (mean, 3.4±0.3) compared to groups H (2.9±0.2 apoptotic bodies per optical field) and CC (2.9±0.3). Interleukin-6 expression was increased in all study groups being more pronounced in group H (2.8) compared to groups SCC (1.0) and CC (1.5). Tumor necrosis factor-α and nuclear factor-κB expression was equally increased in all study groups.

Conclusion:
Both RF-assisted hepatectomy techniques increased the expression of tissue injury markers on remnant liver, while only the SCC technique resulted in mild histologic lesions at 48 hours post operation.