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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 6/2011

01-06-2011 | Hepatobiliary Tumors

Continuous Occlusion of Hepatic Artery Proper for Prevention of Blood Loss in Partial Hepatectomy for Ruptured Hepatocellular Carcinoma: A Case-Matched Comparative Study

Authors: Feng Xia, MD, PhD, Wan-Yee Lau, MD, FRCS, FACS, FRACS(Hon), Cheng Qian, MD, PhD, Kuansheng Ma, MD, PhD, Xiaowu Li, MD, PhD, Ping Bie, MD, PhD

Published in: Annals of Surgical Oncology | Issue 6/2011

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Abstract

Background

To investigate the efficacy and safety of adding continuous occlusion of hepatic artery proper to intermittent Pringle maneuver in partial hepatectomy for ruptured hepatocellular carcinoma.

Materials and Methods

This is a retrospective study on data that were prospectively collected and entered into a computer database. A total of 36 patients who underwent partial hepatectomy for ruptured HCC by adding continuous occlusion of hepatic artery proper to intermittent Pringle maneuver at a tertiary care university hospital were compared with a historical case-matched control group of 36 patients who received intermittent Pringle maneuver only.

Results

The patient characteristics were comparable for the 2 groups of patients. The mean hepatic artery occlusion time was 58 min (range 36–98 min). Intraoperative blood loss and blood transfusion rate in the study group were significantly lower than the control group (P < .001 and P = .004, respectively). There were no significant differences in the postoperative serum aspartate transaminase and total bilirubin levels (P = .087, P = .135, respectively), and in the postoperative hospital stay and surgical complications according to Clavien’s classification between the two groups (P = 0.213, P = 1.000, respectively). The disease-free survival rates in the study group was significantly better than the control group (P = .023). Overall, HCC patients with rupture had poor prognosis.

Conclusions

The addition of continuous occlusion of hepatic artery proper to intermittent Pringle maneuver significantly reduced intraoperative blood loss for partial hepatectomy in patients with ruptured HCC when compared with intermittent Pringle maneuver alone. The procedure was found to be safe even for patients with liver cirrhosis.
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Metadata
Title
Continuous Occlusion of Hepatic Artery Proper for Prevention of Blood Loss in Partial Hepatectomy for Ruptured Hepatocellular Carcinoma: A Case-Matched Comparative Study
Authors
Feng Xia, MD, PhD
Wan-Yee Lau, MD, FRCS, FACS, FRACS(Hon)
Cheng Qian, MD, PhD
Kuansheng Ma, MD, PhD
Xiaowu Li, MD, PhD
Ping Bie, MD, PhD
Publication date
01-06-2011
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 6/2011
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-010-1484-3

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