Comparison of different methods of hepatic blood flow occlusion in hepatectomy for hepatic alveolar echinococcosis / 中华肝胆外科杂志

ABSTRACT

Objective:To compare the different methods of hepatic blood flow occlusion in hepatectomy for hepatic alveolar echinococcosis.Methods:A total of 49 patients with hepatic alveolar echinococcosis who underwent radical hepatectomy from January 2018 to January 2019 in Department of General Surgery, Qinghai Provincial People's Hospital were retrospectively studied. There were 22 males and 27 females, aged 10-62 years. The patients were divided into the Glisson group ( n=22) and the Pringle group ( n=27) according to the method used for hepatic blood flow occlusion during operation. For the Glisson group, intrahepatic blood flow was occluded at the Glisson pedicle. For the Pringle group, intrahepatic blood flow was occluded using the Pringle’s maneuvre. Intraoperative blood loss, operation time, postoperative liver function and postoperative complications were compared between the two groups. Results:There were no significant differences between the two groups in operation time, intraoperative blood loss and intraoperative blood transfusion (all P>0.05). The vascular occlusion time of blood flow in the Pringle group was 35 (30, 45) min, which was significantly longer than that of 20 (15, 26) min in the Glisson group ( P<0.05). The drainage tube in the Pringle group was removed after 8 (7, 12) d, which was significantly longer than that of 7 (6, 9) d in the Glisson group ( P<0.05). After operation, alanine aminotransferase, aspartate aminotransferase, total bilirubin and direct bilirubin in the Glisson group were significantly better than those in the Pringle group (all P<0.05). Postoperative complications occurred in 9 patients (40.9%, 9/22) in the Glisson group and 15 patients (55.6%, 15/27) in the Pringle group ( P>0.05). Conclusion:The liver function, and time of removal of abdominal drainage tube after Glisson pedicle hepatic blood flow occlusion in patients who underwent hepatectomy for hepatic alveolar echinococcosis were significantly better than the Pringle method.