Randomized clinical trial of liver resection with and without hepatic pedicle clamping.
BACKGROUND
The purpose of this study was to compare the perioperative outcome of liver resection with and without intermittent hepatic pedicle clamping.


METHODS
Between June 2002 and June 2004, 126 consecutive patients with resectable liver tumours were randomized to undergo resection with (63 patients) or without (63 patients) intermittent hepatic pedicle clamping.


RESULTS
The transection time was significantly higher in the group without hepatic pedicle clamping. The blood loss per cm(2) was similar in the two groups: 2.7 ml/cm(2) in the group with versus 3.2 ml/cm(2) in group without hepatic pedicle clamping (P = 0.425). In the subset of patients with an abnormal liver, there were no differences in blood loss per transection surface: 3.1 ml/cm(2) in the group with versus 2.9 ml/cm(2) in the group without clamping (P = 0.829). The rate of blood transfusions was not higher in the non-clamping group. No differences were observed in the postoperative liver enzyme serum levels, the in-hospital mortality (one patient in each group) or the number of complications.


CONCLUSIONS
This study showed clearly that liver resection without hepatic pedicle clamping is safe, even in patients with a diseased liver.
Capussotti
L
L
Division of Surgical Oncology, Institute of Cancer Research and Treatment, Candiolo, Turin, Italy. lcapusotti@mauriziano.it
Muratore
A
A
Ferrero
A
A
Massucco
P
P
Ribero
D
D
Polastri
R
R
D000368:Aged; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D003250:Constriction; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D007902:Length of Stay; D008113:Liver Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control; D016896:Treatment Outcome