[Extensive liver resection according to redox theory].
Postoperative mortality and morbidity are determined by intraoperative stress calculated by changes in arterial ketone body ratio (AKBR) during hepatectomy. In this report, we introduced two types of operative procedure which aims not to decrease AKBR during operation. One is total vascular exclusion (HVE) for liver resection using venovenous bypass which improved the deleterious effects of portal pooling and decreased return of blood to heart. The other is the hepatic resection applying the technique used in the transplantation from the living related donor. In this procedure, the remnant liver works for decreasing the intraoperative stress. The tumor involving lobe is removed under cold perfusion and the tumor is removed on the back table. Then, the tumor free liver is transplanted to the same position.
Yamaoka
Y
Y
Second Department of Surgery, Kyoto University Faculty of Medicine, Japan.
Kumada
K
K
Takayasu
T
T
Ino
K
K
Shimahara
Y
Y
Tanaka
K
K
Ozawa
K
K
D006528:Carcinoma, Hepatocellular / Q000601:surgery*; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D007657:Ketone Bodies / Q000097:blood*; D008113:Liver Neoplasms / Q000601:surgery*
D007657:Ketone Bodies