Total Vascular Exclusion of the Liver During Hepatic Surgery

摘要: Objectives: To review our experience with total vascular exclusion of the liver and to assess its role in hepatic resections. Design: Retrospective survey. Setting: University hospital, a tertiary referring center for surgical diseases. Patients: A 722 patients who underwent resections from November 1, 1981, March 31, 1996, whom 19 (2.6%) required because lesions closely adherent or infiltrating retrohepatic vena cava centrally located liver, strictly contact vein convergence. Main Outcome Measure: χ 2 Test qualitative data Student t test categorical data. Results: Of carried out under exclusion, 6 had tumoral infiltration cava: 4 cases venous wall was partially resected, while remaining it completely removed replaced prosthetic graft. There were no operative deaths. resections, 227 major hepatectomies: 74 (32.6%) performed after ligation glissonian elements hemiliver be removed, without clamping pedicle, further 36 (15.8%) any preliminary control. significant reduction intraoperative blood transfusions achieved despite performance more extended operations, regardless technique used. Conclusions: Total is useful tool controlling inflow but true need during resection limited. Its requires well-trained team familiar problems regarding access inferior prolonged occlusion pedicle cava. Arch Surg. 1997;132:1104-1109