In situ and surface liver cooling with prolonged inflow occlusion during hepatectomy in patients with chronic liver disease.
OBJECTIVE
We examined in situ and surface liver hypothermia with continuous and prolonged inflow occlusion during hepatic resection (segmentectomy or subsegmentectomy).


METHODS
Eight patients with cirrhosis and three with chronic hepatitis.


METHODS
In situ chilling was achieved by introducing cold Ringer's lactate solution through the portal vein, under conditions of portal triad occlusion.


RESULTS
The liver tissue temperature fell to a mean of 28.4 degrees C 5 minutes later. The time of ischemia ranged from 32 to 52 minutes (mean +/- SD, 47.8 +/- 5.6 minutes). The mean blood loss was significantly lower than in our conventional hepatectomy series (680 vs 1520 mL, P < .02).


RESULTS
There were no serious complications, and hypoxia-induced liver injury was ameliorated, as shown by liver function tests.


CONCLUSIONS
Hepatectomy with prolonged inflow occlusion is justified in low-risk patients with chronic liver disease if it is combined with liver hypothermia, such as simple in situ and surface cooling.
Kim
Y I
YI
Department of Surgery I, Oita Medical University, Japan.
Kobayashi
M
M
Nakashima
K
K
Aramaki
M
M
Yoshida
T
T
Mitarai
Y
Y
D000368:Aged; D016063:Blood Loss, Surgical; D001803:Blood Transfusion; D001810:Blood Volume; D001831:Body Temperature; D002908:Chronic Disease; D005069:Evaluation Studies as Topic; D005112:Extracorporeal Circulation / Q000379:methods*; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006509:Hepatitis B / Q000097:blood / Q000150:complications / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D006526:Hepatitis C / Q000097:blood / Q000150:complications / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods*; D007552:Isotonic Solutions; D008102:Liver Circulation; D008103:Liver Cirrhosis / Q000097:blood / Q000150:complications / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D000077325:Ringer's Lactate; D012720:Severity of Illness Index
D007552:Isotonic Solutions; D000077325:Ringer's Lactate