Central hepatectomy using hepatic blood flow exclusion and CUSA / 中华普通外科杂志

ABSTRACT

Objective To improve the resection rate of central type hepatoma. Method Under selective exclusion of hepatic blood flow and the use of caritational ultrasonic surgical aspiration (CUSA), hepatectomy of central hepatic segments was performed for liver tumors. Result There were 46 cases in this group. Preoperative hepatic function was Child A in 43 cases and Child B in 3 cases. Regional entire bloodstream was excluded ranging from 8 to 33 minutes in 39 cases, Intraoperative blood loss was 100 to 2400 ml,the average was 490 ml. Postoperative hepatic function recovery to Child A grade in 43 cases within one week, postoperative aacites developed in 3 cases, jaundice in 1 case, biliary fistula in 1 case, gastroplegia in 1 case. One patient died of myocardial infarction 3 days postoperatively. Thirty-five malignant cases were followed-up with a mean period of 9 months, one died of intraabdominal metastasis 10 months postoperatively, the other 34 cases was alive without recurrence. Conclusion Hepatic regional entire bloodstream exclusion is effective in the control of intraoperative blood loss ; Hypersound-emulsifying- attractor separates blood vessels and bile ducts in hepatic hilar region. The combination of these two techniques helps in the resection of central hepatic tumors.