title: Effect of selective inflow occlusion on hemodynamic conditions during laparoscopic left hemihepatectomy effect of selective inflow occlusion on hemodynamic conditions during laparoscopic left hemihepatectomy.
abstract: OBJECTIVE
  Selective inflow occlusion instead of portal triad clamping was used during laparoscopic left hemihepatectomy in our institution. This study observed its hemodynamic effects during operation.
  
  
  METHODS
  Hemodynamic parameters including heart rate (HR), mean arterial pressure (MAP), central venous pressure (CVP), mean pulmonary artery pressure (PAP), pulmonary capillary wedge pressure (PCWP), cardiac index (CI), systemic vascular resistance (SVR) and pulmonary vascular resistance (PVR) were collected at 6 time points: after induction, after insufflation with CO2, after patient in reverse Trendelenburg position, after left branch of hepatic artery was occluded, after left branch of portal vein was occluded and after desufflation with patient supine.
  
  
  RESULTS
  No severe perioperative cardiopulmonary complications were observed. Occlusion of left branch of hepatic artery brought no significant hemodynamic change. Occlusion of left branch of portal vein increased CVP and CI and decreased SVR. CO2 inflation caused HR, MAP and SVR to increase. The change to reverse Trendelenburg position caused CVP and PAP to decrease. When placed in the supine position with deflation, MAP, CVP, PAP, PCWP and CI went to a higher than base level. HR and SVR returned to base level.
  
  
  CONCLUSIONS
  Using selective inflow occlusion in laparoscopic left hemihepatectomy caused few hemodynamic changes before and after occlusion in patients without cardiopulmonary diseases. However, the change of position and inflation or deflation caused significant changes.
authors.affiliation: Department of Anesthesiology, Zhejiang University, Hangzhou, China.
authors.forename: Chun-Yan
authors.initials: CY
authors.lastname: Yan
authors.forename: Xiu-Jun
authors.initials: XJ
authors.lastname: Cai
authors.forename: Yi-Fan
authors.initials: YF
authors.lastname: Wang
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001794:Blood Pressure; D002245:Carbon Dioxide / Q000008:administration & dosage; D002302:Cardiac Output; D002407:Catheterization, Swan-Ganz; D005260:Female; D006339:Heart Rate; D006439:Hemodynamics; D006498:Hepatectomy / Q000379:methods*; D006499:Hepatic Artery / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007327:Insufflation; D010535:Laparoscopy; D008099:Liver / Q000098:blood supply* / Q000601:surgery*; D008102:Liver Circulation; D008297:Male; D008875:Middle Aged; D056888:Patient Positioning; D011028:Pneumoperitoneum, Artificial; D011169:Portal Vein / Q000503:physiopathology / Q000601:surgery*; D012039:Regional Blood Flow; D013997:Time Factors; D014655:Vascular Resistance
chemical_list: D002245:Carbon Dioxide