[The effect of different hepatic vascular exclusion for massive hemorrhage in hepatectomy].
OBJECTIVE
To analyze the effect of different hepatic vascular exclusions for massive hemorrhage in hepatectomy.


METHODS
The clinical data of 2238 cases with hepatectomy treated from January 1995 to August 2009 was analyzed retrospectively in the cause of massive hemorrhage (blood loss ≥ 1000 ml), blood loss during liver resection and massive hemorrhage incidence with different methods of hepatic vascular exclusion.


RESULTS
Among 2238 cases received hepatectomy, 215 cases (9.6%) had massive hemorrhage because of portal vein tumor thrombus extraction (26.0%), extensive adhesions around the tumor (24.7%), section of liver hemorrhage (23.7%), hepatic vascular injury (15.8%), and tumor rupture (9.8%). Among 2182 cases received hepatectomy without portal vein tumor thrombus extraction, 159 cases (7.3%) had massive hemorrhage, 1257 cases (57.6%) which blood loss were less than 400 ml. Hepatectomy with different hepatic vascular exclusion methods had different blood loss and massive hemorrhage incidence.


CONCLUSIONS
Pringle combined with clamping infrahepatic vena cava method and the liver double-hanging maneuver through the retrohepatic avascular tunnel on the right of the inferior vena cava method can reduce blood loss and massive hemorrhage incidence in hepatectomy more effectively, especially for huge liver tumor resection.
Liu
Jing-feng
JF
Liver Center, the First Affiliated Hospital of Fujian Medical University, Fuzhou, China. drjingfeng@yahoo.com.cn
Chi
Min-hui
MH
Zeng
Jin-hua
JH
Zeng
Yong-yi
YY
Luo
Shun-feng
SF
Lin
Ke-can
KC
Li
Ling
L
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008099:Liver / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult