[Is extracorporeal liver surgery useful for difficult hepatic resections?].
Five cases of hepatic tumor deemed unresectable by conventional techniques are presented to illustrate the potential benefit offered by complete hepatic vascular exclusion (Pringle maneuver associated with inferior vena cava clamping below and above the liver). The most extensive and difficult liver resections may be achieved, with possible venous reconstruction, if the clamping period is not interrupted. Hepatic vascular exclusion may exceed one hour, up to 85 minutes in this series, with a good liver tolerance, in the absence of preoperative liver dysfunction. The advantages and disadvantages of the ex situ extracorporeal liver resections performed under similar circumstances are discussed. The authors consider that the role of ex situ liver procedures should be very limited.
Huguet
C
C
Département de Chirurgie, Centre Hospitalier Princesse Grâce, Monaco.
Gavelli
A
A
Harb
J
J
Mansvelt
B
B
Vorburger
T
T
Roger Clément
R
R
Mac Namara
M
M
D000328:Adult; D003110:Colonic Neoplasms / Q000473:pathology; D005260:Female; D006391:Hemangioma / Q000000981:diagnostic imaging / Q000601:surgery*; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008303:Malignant Carcinoid Syndrome / Q000473:pathology; D008875:Middle Aged; D011183:Postoperative Complications; D011859:Radiography; D012086:Reoperation
La chirurgie ex situ du foie est-elle utile au cours des résections hépatiques difficiles?