title: Hepatectomy including more than half of liver volume with intermittent portal triad occlusion.
abstract: BACKGROUND
  Liver resections over 50% of hepatic volume can be achieved with a low morbi-mortality, although occasionally they are followed by severe complications. Postoperative evolution and complications after this type of hepatic resections with intermittent occlusion of the portal triad have been studied.
  
  
  METHODS
  13 right hepatectomies, 5 enlarged right hepatectomies and 2 enlarged left hepatectomies were performed consecutively, with intraoperative ultrasound evaluation and intermittent portal triad occlusion.
  
  
  RESULTS
  Maximum time of continuous hepatic hilum occlusion was 15 minutes, with a mean isquemia time of 25 +/- 8.6 minutes. Peak of disturbance of hepatic function was at 24 hours and recovered totally at 7th postoperative day. Nine of the 20 patients (45%) did not need intraoperative transfusion and the average of transfusion was 1.8 +/- 1.9 blood units. Four biliary leaks (20%), with no severe hepatic disfunction were observed during postoperative period, and there was no hospital mortality.
  
  
  CONCLUSIONS
  Intermittent portal triad occlusion during hepatic resections in more than 50% of liver volume is a safe surgical maneuver.
authors.affiliation: Departamento de Cirugía General, Hospital General Universitario Gregorio Marañón, Madrid.
authors.forename: J
authors.initials: J
authors.lastname: Calleja Kempín
authors.forename: J
authors.initials: J
authors.lastname: Guarnizo Clemente
authors.forename: J
authors.initials: J
authors.lastname: Martín Cavanna
authors.forename: R
authors.initials: R
authors.lastname: Vázquez Perfecto
authors.forename: P
authors.initials: P
authors.lastname: Jiménez Almonacid
authors.forename: A
authors.initials: A
authors.lastname: Muro de la Fuente
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008107:Liver Diseases / Q000601:surgery*; D008113:Liver Neoplasms / Q000601:surgery; D008297:Male; D008875:Middle Aged