Liver resection with selective hepatic vascular exclusion: a cohort study.
OBJECTIVE
To report our experience on the safety and efficacy of hepatic resection under selective hepatic vascular exclusion (SHVE).


METHODS
SHVE was used in 246 consecutive patients undergoing major or complex liver resection in our center. Preoperative demographic and clinical data, details of the surgical procedure, pathologic diagnosis, postoperative course, and complications were collected prospectively.


RESULTS
From January 2000 to July 2007, liver resections were performed under SHVE in 246 patients; total SHVE, right partial SHVE, and left partial SHVE in 145, 54, and 47 patients, respectively. SHVE was converted to total hepatic vascular exclusion in 3 patients because the tumor invaded the wall of the inferior vena cava. Hemodynamic tolerance to SHVE was excellent, with only a slight increase in systemic and pulmonary vascular resistance during clamping. There were no deaths and the morbidity rate was 24.8%. The mean hospital stay was 9.6 days (range, 8-18).


CONCLUSIONS
Our study showed that SHVE was safe, efficacious, and it was applicable to liver tumors which were near, but had not invaded into the inferior vena cava.
Fu
Si-Yuan
SY
The Third Department of Hepatic Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China.
Lai
Eric C H
EC
Li
Ai-Jun
AJ
Pan
Ze-Ya
ZY
Yang
Yuan
Y
Sun
Yu-Min
YM
Lau
Wan Yee
WY
Wu
Meng-Chao
MC
Zhou
Wei-Ping
WP
D000293:Adolescent; D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003250:Constriction; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006488:Hemostasis, Surgical / Q000379:methods*; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control; D008099:Liver / Q000098:blood supply* / Q000601:surgery; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011300:Preoperative Care / Q000379:methods; D011336:Probability; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis; D016896:Treatment Outcome; D014682:Vena Cava, Inferior; D055815:Young Adult