Use of transportal balloon catheter occlusion of the portal triad in prevention of bleeding during liver resection.
BACKGROUND
Operative blood loss is among the most important factors determining the prognosis of patients undergoing hepatic resection. The best method for preventing bleeding is preliminary selective vascular occlusion of lobar, sectoral, or segmental portal triads, although not always technically feasible.


METHODS
Transportal occlusion of the portal triad with a balloon catheter was used in 35 hepatectomies for various tumors.


RESULTS
In 27 out of 35 resections, there was absence or minimal bleeding from afferent vessels (portal vein, hepatic artery). In the remaining eight cases, there was significant bleeding from the hepatic artery. In these cases, transportal occlusion of portal triad was combined with a temporary interruption of the hepatic artery after the dissection of the hepatoduodenal ligament. The average intraoperative blood loss was 350-1,500 ml.


CONCLUSIONS
The use of a balloon catheter occlusion of the portal triad during liver resection is often technically feasible. It facilitates temporary occlusion of hardly accessible portal veins in the hepatic hilus without their prior exposure and minimizes bleeding.
Sarely Israelashvili
Meirav
M
Department of Surgery C and Surgical Oncology, Chaim Sheba Medical Center, Tel Hashomer, Israel.
Zippel
Douglas B
DB
Koller
Moshe
M
Valeanu
Adrian
A
Scott
Danny
D
Ayalon
Shlomo
S
Ben Ari
Gur Y
GY
Papa
Moshe Z
MZ
D000328:Adult; D000368:Aged; D021721:Balloon Occlusion / Q000379:methods*; D005260:Female; D006488:Hemostasis, Surgical / Q000379:methods*; D006498:Hepatectomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011168:Portal System