Application of hemihepatic vascular occlusion with hanging maneuver in hepatectomy.
OBJECTIVE
To evaluate the hemihepatic vascular occlusion with hanging maneuver in hepatectomy.


METHODS
Ninety-four cases of hepatectomy were analyzed retrospectively. All patients were randomized into 3 groups: Pringle maneuver was applied in Group 1 (n=40), hemihepatic inflow control was Group 2 (n=30) and complete hemihepatic vascular occlusion with hanging maneuver was applied in Group 3 (n=24).The clamping period, operation time, bleeding volume, blood transfusion volume, postoperative recovery of liver function and postoperative complications were compared among three groups.


RESULTS
The average times of clamping in Group 1 was 1.6 +/- 0.7, but only one clamping in Group 2 and 3. There were significant differences among three groups in bleeding volume as well. The postoperative serum ALT and total bilirubin (TBIL) in Group 2 and 3 were significantly lower than those of Group 1.5 patients died of liver failure after operation in Group 1. But liver failure or morbidity wasn't happened in Group 2 and 3. The rates of biliary leakage in Group 1 and 2 were more than that of Group 3. The hospitalization duration of Group 1 was significantly longer than those of Group 2 and 3.


CONCLUSIONS
Hemihepatic vascular occlusion with hanging maneuver, which can reduce bleeding volume and enhance the recovery of liver function, is safe and practicable, especially for patients with liver cirrhosis.
Wen
Yu
Y
Division of Hepatobiliary Disease, Department of General Surgery Second Xiangya Hospital of Central South University, Changsha 410011, China.
Miao
Xiongying
X
Xiong
Li
L
Xiong
Ge
G
Hu
Jixiong
J
Zhong
Dewu
D
Li
Qinglong
Q
Liu
Wei
W
D000328:Adult; D016063:Blood Loss, Surgical / Q000517:prevention & control / Q000706:statistics & numerical data; D001803:Blood Transfusion / Q000706:statistics & numerical data; D006528:Carcinoma, Hepatocellular / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008099:Liver / Q000098:blood supply*; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D020127:Recovery of Function; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome