title: Treatment for postoperative liver failure after major hepatectomy under hepatic total vascular exclusion.
abstract: Hepatic total vascular exclusion (HTVE) with clamping of the portal triad and the inferior vena cava below and above the liver is a useful technique in the resection of major hepatic lesions situated close to the hepatic veins and inferior vena cava. From 1996 to 2000, five patients underwent major hepatectomy under HTVE; among these, liver failure occurred in two patients because of liver cirrhosis or hepatic artery interruption. In the former case, apheresis therapy (plasma exchange: 9 times), continuous prostaglandin E, (PGE,) infusion via the hepatic artery(0.01 tg/kg/min) for 7 days, and hyperbaric oxygen therapy (3 times: 2 ATA, 60 min) were applied. In the latter case, apheresis therapy (plasma exchange: 9 times, continuous hemodiafiltration: 12 days) and continuous PGE, infusion via the superior mesenteric artery for 7 days were applied. With these treatment modalities, both cases were cured of postoperative liver failure.
authors: School of Health Sciences, Faculty of Medicine, Akita University, japan. asa@ams.akita-u.ac.jp
authors: Yoshihiro
authors: Y
authors: Asanuma
authors: Tsutomu
authors: T
authors: Sato
authors: Ouki
authors: O
authors: Yasui
authors: Toshiaki
authors: T
authors: Kurokawa
authors: Kenji
authors: K
authors: Koyama
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000601:surgery; D003250:Constriction; D005260:Female; D006391:Hemangioma / Q000601:surgery; D006498:Hepatectomy / Q000009:adverse effects*; D006499:Hepatic Artery / Q000601:surgery*; D006801:Humans; D017093:Liver Failure / Q000209:etiology* / Q000628:therapy*; D008113:Liver Neoplasms / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000601:surgery*; D014682:Vena Cava, Inferior / Q000601:surgery*