title: In situ and surface liver cooling with prolonged inflow occlusion during hepatectomy in patients with chronic liver disease.
abstract: 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.
authors.affiliation: Department of Surgery I, Oita Medical University, Japan.
authors.forename: Y I
authors.initials: YI
authors.lastname: Kim
authors.forename: M
authors.initials: M
authors.lastname: Kobayashi
authors.forename: K
authors.initials: K
authors.lastname: Nakashima
authors.forename: M
authors.initials: M
authors.lastname: Aramaki
authors.forename: T
authors.initials: T
authors.lastname: Yoshida
authors.forename: Y
authors.initials: Y
authors.lastname: Mitarai
mesh_terms: 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
chemical_list: D007552:Isotonic Solutions; D000077325:Ringer's Lactate