Back-flow bleeding control during resection of right-sided liver tumors by means of ultrasound-guided finger compression of the right hepatic vein at its caval confluence.
OBJECTIVE
Limiting the backflow bleeding from the hepatic veins is a priority in liver resections. We describe an ultrasound-guided technique for backflow bleeding control from the right hepatic vein (RHV) during right-sided liver resection.


METHODS
Right surface of the extrahepatic RHV is exposed to allow its compression by surgeon's finger-tips: the effectiveness of finger compression is checked by color-Doppler intraoperative ultrasonography.


RESULTS
This technique was adopted in 47 consecutive patients with tumors located in the right segments and not infiltrating the RHV close to its caval confluence. There was no hospital mortality or major morbidity. Mean blood loss was 310 mL, and 4 patients required blood transfusion. The maneuver here described was used 2.3 times per patients, and taping of the RHV was never needed.


CONCLUSIONS
The technique here described allows easy and safe control of the RHV patency without its skeletonization and encirclement.
Torzilli
Guido
G
3rd Department of Surgery, Istituto Clinico Humanitas, IRCCS, University of Milan, Rozzano, Milano, Italy. guido.torzilli@unimi.it
Donadon
Matteo
M
Palmisano
Angela
A
Del Fabbro
Daniele
D
Spinelli
Antonino
A
Makuuchi
Masatoshi
M
Montorsi
Marco
M
D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical; D005260:Female; D006488:Hemostasis, Surgical / Q000379:methods*; D006503:Hepatic Veins / Q000000981:diagnostic imaging*; D006801:Humans; D008113:Liver Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011312:Pressure; D014463:Ultrasonography