[Role and significance of extrahepatic control of hepatic vein and inferior vena cava in difficult hepatectomies for patients with liver tumors].
OBJECTIVE
To explore the role of extrahepatic control on blood flow of hepatic vein and inferior vena cava in hepatectomy, and observe its effect on minimizing hemorrhage.


METHODS
From 2001 to April 2003, 33 patients who had liver tumors involving segment IV, VII, VIII or half liver underwent major hepatectomies that required exposure of the inferior vena cava and main trunks of hepatic veins, during which the major hepatic veins and inferior vena cava were isolated and taped to control blood flow when necessary.


RESULTS
In 33 attempts, 32 were successful and all tumors were resected successfully. The placement of occlusion tape was unsuccessful in 1 case. 7 cases did not need blood transfusion during operation. The amount of blood transfusion for other cases were form 0 to 1 600 ml. there was no operative mortality.


CONCLUSIONS
Appropriate control of main truck of hepatic vein and inferior vena cava is effective in reducing blood loss during hepatectomies. It is also very helpful for performing difficult hepatectomies.
Peng
Shu-you
SY
Department of General Surgery, Second Hospital, Medical College of Zhejiang University, Hangzhou 310009, China. sypeng@mail.hz.zj.cn
Liu
Ying-bin
YB
Xu
Bin
B
Cai
Xiu-jun
XJ
Mu
Yi-ping
YP
Wu
Yu-lian
YL
Cao
Li-ping
LP
Fang
He-qing
HQ
Wang
Jian-wei
JW
Li
Hai-jun
HJ
Li
Jiang-tao
JT
Wang
Xin-bao
XB
Deng
Gui-long
GL
D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000601:surgery*; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects / Q000379:methods*; D006500:Hepatic Duct, Common / Q000601:surgery; D006503:Hepatic Veins / Q000601:surgery*; D006801:Humans; D008099:Liver / Q000098:blood supply / Q000473:pathology; D008103:Liver Cirrhosis / Q000209:etiology; D008113:Liver Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D014682:Vena Cava, Inferior / Q000601:surgery*