Modified technique of hepatic vascular exclusion: effect on blood loss during complex mesohepatectomy in hepatocellular carcinoma patients with cirrhosis
| Autor: | Song-qing He, Bixiang Zhang, Zhi-yong Huang, Zhi-wei Zhang, Xiaoping Chen, Yi-fa Chen, Fazu Qiu, Wanguang Zhang |
|---|---|
| Rok vydání: | 2005 |
| Předmět: |
Adult
Liver Cirrhosis Male medicine.medical_specialty Cirrhosis Blood transfusion Carcinoma Hepatocellular medicine.medical_treatment Blood Loss Surgical Hemodynamics Vena Cava Inferior Inferior vena cava Gastroenterology Liver Function Tests Internal medicine Occlusion medicine Hepatectomy Humans Aged Chi-Square Distribution business.industry Liver Neoplasms Middle Aged medicine.disease Constriction Surgery Cardiac surgery Logistic Models Treatment Outcome medicine.vein Liver Hepatocellular carcinoma Female business Abdominal surgery |
| Zdroj: | Langenbeck's archives of surgery. 391(3) |
| ISSN: | 1435-2443 |
| Popis: | Hepatic veins remain patent during complete inflow occlusion (CIO) and bleeding from them may continue. Occlusion of the inferior vena cava (ICV) during CIO may reduce blood loss from hepatic veins. This study was designed to compare the overall outcomes after application of CIO with or without occlusion of the ICV below the liver in complex mesohepatectomy for hepatocellular carcinoma (HCC) patients with cirrhosis. One hundred and eighteen (118) patients were randomly assigned to CIO or a modified technique of hepatic vascular exclusion (MTHVE). Hemodynamic parameters were evaluated and the amount of blood loss, measurement of liver enzymes, and postoperative progress were recorded. Blood loss during liver transection in CIO groups was significantly greater than that in MTHVE group (P=0.046). Thus, incidence of blood transfusion was significantly greater in patients of the CIO group (P=0.041). There were no significant differences in liver enzyme changes, bilirubin, or morbidity in the postoperative period between the two groups. CIO with occlusion of the ICV below the liver is a safe, effective, and feasible technique during mesohepatectomy in HCC patients with cirrhosis. Excellent results were obtained with minimized bleeding, limited hepatic function damage, and low rate of postoperative complications. |
| Databáze: | OpenAIRE |
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