title: A comparative study assessing a new tool for occluding parenchymal blood flow during liver resection for hepatocellular carcinoma.
abstract: BACKGROUND
  The aim of this study was to compare the efficacy of a new tool (the hepatic section vascular blocker, HSVB) with hepatic pedicle clamping and hemihepatic vascular exclusion to control bleeding during liver resection for cancer.
  
  
  METHODS
  Clinical data on 117 patients who underwent liver resection from 2004 to 2009 were analysed retrospectively. Forty-two patients had liver resection using the HSVB (group A), in 35 patients hemihepatic vascular exclusion was used (group B), and in 40 patients hepatic pedicle clamping with a Pringle manoeuvre was used (group C). Blood loss, operative time, postoperative hepatic function and complications were compared.
  
  
  RESULTS
  Mean blood loss and operative time in group A were significantly less than in groups B (p=0.026 and p<0.001, respectively) and C (p<0.001 and p<0.001). There were significant differences between groups A and C in total bilirubin (TB) and alanine transaminase (ALT) levels on postoperative days 3 and 7, and group A had better hepatic function (TB p=0.014 and p=0.009; ALT p<0.001 and p<0.001). The rate of postoperative ascites was significantly higher in group C compared with group A (p<0.001). In group C, 2 patients had liver failure, 1 had a gastro-intestinal haemorrhage and 1 died.
  
  
  CONCLUSIONS
  Using the HSVB during liver resection effectively controlled bleeding, saved operative time and preserved hepatic function. It proved to be a safe and feasible technique.
authors.affiliation: Department of General Surgery, Southeast Affiliated Hospital of Xiamen University, Zhangzhou, Fujian Province, China.
authors.forename: S
authors.initials: S
authors.lastname: Zhou
authors.forename: X-J
authors.initials: XJ
authors.lastname: Xue
authors.forename: R-R
authors.initials: RR
authors.lastname: Li
authors.forename: D-F
authors.initials: DF
authors.lastname: Chen
authors.forename: W-Y
authors.initials: WY
authors.lastname: Chen
authors.forename: G-X
authors.initials: GX
authors.lastname: Liu
authors.forename: E-M
authors.initials: EM
authors.lastname: Ke
authors.forename: S-Y
authors.initials: SY
authors.lastname: Zheng
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D001663:Bilirubin / Q000097:blood; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D006528:Carcinoma, Hepatocellular / Q000601:surgery*; D002648:Child; D005260:Female; D006498:Hepatectomy / Q000295:instrumentation*; D006801:Humans; D008099:Liver / Q000098:blood supply* / Q000502:physiology / Q000601:surgery; D008113:Liver Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D000410:Alanine Transaminase; D001663:Bilirubin