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01-03-2009 | Original Article

Half clamping of the infrahepatic inferior vena cava reduces bleeding during a hepatectomy by decreasing the central venous pressure

Authors: Kazuhisa Uchiyama, Masaki Ueno, Satoru Ozawa, Shinya Hayami, Manabu Kawai, Masaji Tani, Kazuhiro Mizumoto, Masanori Haba, Yoshio Hatano, Hiroki Yamaue

Published in: Langenbeck's Archives of Surgery | Issue 2/2009

Abstract

Background and aims

Bleeding from the hepatic vein is closely related to central venous pressure (CVP). To evaluate the effect of low central venous pressure during a hepatectomy, the infrahepatic inferior vena cava (IVC) was half clamped.

Patients and methods

Between 2006 and 2007, 20 patients undergoing major hepatectomy with the IVC half clamping (half-clamping group) were compared with 58 patients undergoing hepatectomy without IVC half clamping between 2003 and 2005 (control group). The types of liver resection, amount of blood loss during the hepatectomy, volume of blood transfusion, length of hospital stay, and complications were compared between the two groups.

Results

In the half-clamping group, blood loss was decreased in comparison to the control group (p = 0.041) and the suprahepatic CVP was low (2.4 ± 1.8 mmHg; p = 0.0002). The diameter at the root of the right hepatic vein was reduced in comparison to before clamping (5.8 ± 1.6 mm; p < 0.001). There were no complications of half clamping on any hemodynamic and blood electrolytic parameters.

Conclusion

Using the half clamping technique of the IVC, intra-operative CVP was maintained below 3 mmHg without any side effects, and the low CVP significantly reduced the bleeding from hepatic veins during a major hepatectomy.

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Title: Half clamping of the infrahepatic inferior vena cava reduces bleeding during a hepatectomy by decreasing the central venous pressure
Authors: Kazuhisa Uchiyama
Masaki Ueno
Satoru Ozawa
Shinya Hayami
Manabu Kawai
Masaji Tani
Kazuhiro Mizumoto
Masanori Haba
Yoshio Hatano
Hiroki Yamaue
Publication date: 01-03-2009
Publisher: Springer-Verlag
Published in: Langenbeck's Archives of Surgery / Issue 2/2009
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-008-0297-3

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Half clamping of the infrahepatic inferior vena cava reduces bleeding during a hepatectomy by decreasing the central venous pressure

Abstract

Background and aims

Patients and methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background and aims

Patients and methods

Results

Conclusion

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