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01-06-2006 | Original Article

Modified technique of hepatic vascular exclusion: effect on blood loss during complex mesohepatectomy in hepatocellular carcinoma patients with cirrhosis

Authors: Xiao-ping Chen, Zhi-wei Zhang, Bi-xiang Zhang, Yi-fa Chen, Zhi-yong Huang, Wan-guang Zhang, Song-qing He, Fa-zu Qiu

Published in: Langenbeck's Archives of Surgery | Issue 3/2006

Abstract

Background

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.

Materials and methods

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.

Results

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.

Conclusions

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.

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Title: Modified technique of hepatic vascular exclusion: effect on blood loss during complex mesohepatectomy in hepatocellular carcinoma patients with cirrhosis
Authors: Xiao-ping Chen
Zhi-wei Zhang
Bi-xiang Zhang
Yi-fa Chen
Zhi-yong Huang
Wan-guang Zhang
Song-qing He
Fa-zu Qiu
Publication date: 01-06-2006
Publisher: Springer-Verlag
Published in: Langenbeck's Archives of Surgery / Issue 3/2006
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-006-0043-7

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Springer Medicine

Modified technique of hepatic vascular exclusion: effect on blood loss during complex mesohepatectomy in hepatocellular carcinoma patients with cirrhosis

Abstract

Background

Materials and methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Materials and methods

Results

Conclusions

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