Methods of vascular control technique during liver resection: a comprehensive review.

摘要: BACKGROUND: Significant hemorrhage together with blood transfusion increases postoperative morbidity and mortality of hepatic resection. Hepatic vascular occlusion is effective in minimizing bleeding during parenchymal transection. This article aimed to review the current role status various techniques resection. DATA SOURCES: The relevant manuscripts were identified by searching MEDLINE, PubMed for articles published between January 1980 April 2010 using keywords ”vascular control”, clamping”, exclusion” ”hepatectomy”. Additional papers a manual search references from key articles. RESULTS: One randomized controlled trial (RCT) 5 RCTs showed intermittent Pringle maneuver ischemic preconditioning followed continuous superior alone, respectively. Two compared outcomes hepatectomy without maneuver. be beneficial, while other failed show any benefit. RCT that had significantly less loss than Four evaluated use hemihepatic occlusion. it maneuver, 3 no significant difference. Only 1 liver injury. No been carried out assess segmental total exclusion (THVE) THVE resulted similar loss, but higher complication. complication rate was similar. Both studies degree one selective (SHVE) injury maneuver. CONCLUSION: Due great variations these studies, difficult draw definitive conclusion on best technique control.