title: [Role and significance of extrahepatic control of hepatic vein and inferior vena cava in difficult hepatectomies for patients with liver tumors].
abstract: 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.
authors.affiliation: Department of General Surgery, Second Hospital, Medical College of Zhejiang University, Hangzhou 310009, China. sypeng@mail.hz.zj.cn
authors.forename: Shu-you
authors.initials: SY
authors.lastname: Peng
authors.forename: Ying-bin
authors.initials: YB
authors.lastname: Liu
authors.forename: Bin
authors.initials: B
authors.lastname: Xu
authors.forename: Xiu-jun
authors.initials: XJ
authors.lastname: Cai
authors.forename: Yi-ping
authors.initials: YP
authors.lastname: Mu
authors.forename: Yu-lian
authors.initials: YL
authors.lastname: Wu
authors.forename: Li-ping
authors.initials: LP
authors.lastname: Cao
authors.forename: He-qing
authors.initials: HQ
authors.lastname: Fang
authors.forename: Jian-wei
authors.initials: JW
authors.lastname: Wang
authors.forename: Hai-jun
authors.initials: HJ
authors.lastname: Li
authors.forename: Jiang-tao
authors.initials: JT
authors.lastname: Li
authors.forename: Xin-bao
authors.initials: XB
authors.lastname: Wang
authors.forename: Gui-long
authors.initials: GL
authors.lastname: Deng
mesh_terms: 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*