title: Effect of infra-hepatic inferior vena cava clamping on bleeding during hepatic dissection: a prospective, randomized, controlled study.
abstract: BACKGROUND
  The success of hepatectomy can be associated with intraoperative blood loss because massive blood loss causes a poor prognosis. This study was designed to evaluate the effect of infrahepatic inferior vena cava (IVC) clamping on the bleeding amount during hepatectomy.
  
  
  METHODS
  Eighty-five patients scheduled to undergo hepatic resection were randomly assigned to the IVC clamping or an IVC nonclamping group according to age, indocyanine green retention rate at 15 minutes, operative procedure, and number of tumors by prospective, randomized method. All analyses were compared by Mann-Whitney U test.
  
  
  RESULTS
  Forty-three patients were assigned to the IVC clamping group and 42 to the nonclamping group (IVC clamping group vs. non-clamping): total blood loss (499 vs. 584 ml; p = 0.567), amount of bleeding during hepatectomy (233 vs. 285 ml; p = 0.474), amount of bleeding during hepatectomy/area of dissection (4.9 vs. 6.6 ml/cm(2); p = 0.63), CVP difference (-3 cmH(2)O vs. -1 cmH(2)O; p < 0.01), and diameter of the right hepatic vein (-2.2 cm vs. 0; p < 0.01).
  
  
  CONCLUSIONS
  Although we had speculated that infrahepatic IVC clamping would reduce blood loss during hepatectomy, we failed to demonstrate any beneficial effects in this clinical setting with low CVP.
authors.affiliation: Second Department of Surgery, Dokkyo University School of Medicine, 880 Kitakobayashi, Mibu, Tochigi, Japan. katomasa@dokkyomed.ac.jp
authors.forename: Masato
authors.initials: M
authors.lastname: Kato
authors.forename: Keiichi
authors.initials: K
authors.lastname: Kubota
authors.forename: Junji
authors.initials: J
authors.lastname: Kita
authors.forename: Mitsugi
authors.initials: M
authors.lastname: Shimoda
authors.forename: Kyu
authors.initials: K
authors.lastname: Rokkaku
authors.forename: Tokihiko
authors.initials: T
authors.lastname: Sawada
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003250:Constriction; D006470:Hemorrhage / Q000601:surgery*; D006488:Hemostasis, Surgical; D006498:Hepatectomy; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D014682:Vena Cava, Inferior / Q000601:surgery*