Clinical application of hepatic venous occlusion for hepatectomy.

摘要: Background Most liver resections require clamping of the hepatic pedicle (Pringle maneuver) to avoid excessive blood loss. But Pringle maneuver can not control backflow bleeding vein. Resection tumors involving veins may cause massive hemorrhage or air embolism from injuries veins. Although total vascular exclusion prevent effectively, it also result in systemic hemodynamic disturbance because inferior vena cava being clamped. Hepatic venous occlusion, a new technique, inflow and outflow without cava. Methods A 71 cases underwent resection with occlusion more than one main All involved second porta hepatis at least Ligation serrefines, tourniquets auricular clamps were used occlusion. Results Of patients, ligation was 28 cases, tourniquet 26, serrefine 17. Right occluded 38 both right middle 2, common trunk left 24, branches all three 5. Thirty-five hemihepatic 4 alternate 23 portal triad plus selective vein 9 The third isolated 26 cases. amount intraoperative loss averaged (540 +/- 283) (range 100 1000) ml group (620 317) 200 - 6000) completely removed. Conclusions applied hepatectomy embolism, is safe effective stable hemodynamics.