title: Hepatectomy under extracorporeal circulation.
abstract: BACKGROUND
  Resection of hepatic tumors located near the confluence of the hepatic vein or invading the inferior vena cava has become technically feasible and relatively safe by using venovenous bypass. However, some technical problems remain to be solved.
  
  
  METHODS
  We performed three cases of hepatic resection under extracorporeal circulation combined with hypothermic perfusion.
  
  
  RESULTS
  An unexpected hemorrhage was observed in all three cases for different causes. The patient of case 2 died of liver failure developed from fatty liver. Bile duct stenosis was observed in cases 1 and 3.
  
  
  CONCLUSIONS
  Although hepatectomy under total vascular exclusion by use of Biopump is now considered a safe procedure, attention should be paid when this procedure is performed because some technical problems still remain.
authors.affiliation: First Department of Surgery, Okayama University Medical School, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Hamazaki
authors.forename: T
authors.initials: T
authors.lastname: Yagi
authors.forename: M
authors.initials: M
authors.lastname: Inagaki
authors.forename: N
authors.initials: N
authors.lastname: Tanaka
authors.forename: H
authors.initials: H
authors.lastname: Mimura
authors.forename: K
authors.initials: K
authors.lastname: Orita
authors.forename: N J
authors.initials: NJ
authors.lastname: Lygidakis
mesh_terms: D016063:Blood Loss, Surgical; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D002758:Cholangiography; D003110:Colonic Neoplasms / Q000473:pathology; D005112:Extracorporeal Circulation; D017809:Fatal Outcome; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D007036:Hypothermia, Induced; D008099:Liver / Q000473:pathology; D017093:Liver Failure; D008113:Liver Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000556:secondary / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged