[The usefulness of monitoring hepatic venous oxygen saturation and mild hypothermia anesthesia in two patients with portal vein tumor emboli during combined portal vein and pancreas resection].
Two patients, a 48-year-old woman and a 61-year-old man, with portal vein tumor emboli underwent pancreaticoduodenectomy combined with portal vein resection. In order to protect the liver during occlusion of the portal vein, we induced mild hypothermia with surface cooling and hepatic oxygen status was monitored by hepatic venous oxygen saturation (ShvO2). During the temporary occlusion of the portal vein, the woman showed a marked decrease in ShvO2, significantly lower than 20%, and continued for about one hour, but on the other hand the man did not. But as the body temperature was raised, they showed the same tendency of decreased ShvO2. Postoperatively, her serum GOT, GPT, T-bilirubin were 104 UI.dl-1, 58 UI.dl-1, 1.95 mg.dl-1 and his data were 62, 42, 1.01 respectively. No other complication were observed. These results suggest that ShvO2 monitoring and mild hypothermia are clinically useful in detecting hepatic oxygen supply/demand unbalance and in protecting the liver.
Department of Anesthesia, Himeji St. Mary's Hospital, Himeji 670-0801.
Mikiko
M
Wake
Yumi
Y
Sanagawa
Yumiko
Y
Okamoto
D000758:Anesthesia / Q000379:methods*; D005260:Female; D006503:Hepatic Veins; D006801:Humans; D007036:Hypothermia, Induced; D008099:Liver / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D009360:Neoplastic Cells, Circulating; D010092:Oximetry; D010190:Pancreatic Neoplasms / Q000601:surgery*; D016577:Pancreaticoduodenectomy; D011169:Portal Vein / Q000601:surgery*; D015427:Reperfusion Injury / Q000517:prevention & control; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures