[Highly-selective regional vascular exclusion for large liver tumor resection].
OBJECTIVE
To evaluate the highly-selective regional vascular exclusion in the risk hepatectomy for liver tumor.


METHODS
Short hepatic veins were ligated and divided followed by the dissection, and isolation of the inflow and outflow vessels of the tumor-bearing lobe, which were completely devascularized after the occlusion of these vessels. The blood loss volume, postoperative recovering situation of the liver function and the incidence of complication were observed in 68 cases.


RESULTS
Main hepatic veins were dissected and isolated exo-hepatically in 65 cases. In the other 3 cases, the main hepatic veins were blocked by Satin skin clamp applied longitudely along the inferior vena cava. Hepatic pedicle was routinely excluded.The amount of blood loss was from 400 to 1200 (600+/-200) mL and 26 (65%) cases didn't receive transfusion.There was no operative mortality and liver function failure. Surgical complications included subphrenic abscess in 2 cases and bile leakage in 2 cases, which were cured conservatively.


CONCLUSIONS
Highly-selective regional exclusion of hepatic blood flow during the risk hepatectomy is safe and effective to prevent massive bleeding and to reduce the incidence of liver failure.
Dai
Wei-dong
WD
Department of Hepatobiliary Surgery, Second Xiangya Hospital, Central South University, Changsha 410011, China.
Hu
Ji-xiong
JX
Zhong
De-wu
DW
Miao
Xiong-ying
XY
Wang
Qun-wei
QW
D000328:Adult; D000368:Aged; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006503:Hepatic Veins / Q000601:surgery*; D006801:Humans; D008099:Liver / Q000098:blood supply / Q000601:surgery*; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D014682:Vena Cava, Inferior / Q000601:surgery