Liver resection without blood transfusion.
A personal series of 58 liver resections was reviewed to identify technical factors minimizing blood transfusions. We identified a concept of vascular isolation prior to parenchymal division (VIP) which used singularly or in combination the following methods of vascular control: parenchymal compression, Pringle maneuver, hepatic venous tourniquet, hilar division, hepatic vein division, and Heaney maneuver. VIP significantly decreased the need for transfusion; of 34 patients with VIP only 2 (6 percent) required transfusion, whereas of 24 patients without VIP, 18 (75 percent) required transfusion (p less than 0.001).
Ryan
J A
JA
Department of Surgery, Virginia Mason Medical Center, Seattle, Washington 98111.
Faulkner
D J
DJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001803:Blood Transfusion; D005069:Evaluation Studies as Topic; D006498:Hepatectomy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies