Application of combined hemihepatic infow and hepatic veins occlusion in major hepatectomy / 中国普通外科杂志

ABSTRACT

Objective To evaluate the effect of application of combined hemihepatic inflow and hepatic veins occlusion in major liver resection.Methods The clinical data of 46 cases of large hepatic carcinoma who underwent liver resection were surveyed retrospectively.The hepatic pedicle of affected side and hepatic veins were dissected and controlled initially,then hepatectomy was performed under the condition of vascular exclusion of the affected side of liver.Results All the 46 cases suffered from hepatocellular carcinoma.The average size of the tumors was 8.3 cm(6-15 cm) in diameter.One main hepatic vein was invaded by tumor in 20 cases and 2 main hepatic veins were invaded by tumor in 14 cases.Among the 46 hepatectomies,right hemihepatectomy was performed in 16,right posterior lobe hepatectomy in 14,and left hemihepatectomy in 16 cases.The mean occlusion time of the hemihepatic pedicle was 30 min(10-45 min),and occlusion time of the hepatic veins was 20 min(10-30 min).The average blood loss was 540 ml(300-1 500 mL).Postoperative complications occurred in 14 cases,and all recovered after treatment.There was no mortality in this series.Conclusions Combined hemihepatic inflow and hepatic veins occlusion in major hepatectomy is a safe,effective and practical vascular exclusion method which can effectively reduce the blood loss and the incidence of the liver function failure.