title: Efficacy and safety of hepatectomy performed with intermittent portal triad clamping with low central venous pressure.
abstract: BACKGROUND
  This retrospective study was designed to investigate the efficacy and safety of intermittent portal triad clamping (PTC) with low central venous pressure (CVP) in liver resections.
  
  
  METHODS
  Between January 2007 and August 2013, 115 patients underwent liver resection with intermittent PTC. The patients' data were retrospectively analyzed.
  
  
  RESULTS
  There were 58 males and 57 females with a mean age of 55 years (± 13.7). Cirrhosis was found in 23 patients. Resections were performed for malignant disease in 62.6% (n = 72) and for benign disease in 37.4% (n = 43). Major hepatectomy was performed in 26 patients (22.4%). Mean liver ischemia period was 27.1 min (± 13.9). The mortality rate was 1.7% and the morbidity rate was 22.6%. Cumulative clamping time (t = 3.61, P < 0.001) and operation time (t = 2.38, P < 0.019) were significantly correlated with AST alterations (D-AST). Cumulative clamping time (t = 5.16, P < 0.001) was significantly correlated with D-ALT. Operation time (t = 5.81, P < 0.001) was significantly correlated with D-LDH.
  
  
  CONCLUSIONS
  Intermittent PTC under low CVP was performed with low morbidity and mortality. Intermittent PTC can be safely applied up to 60 minutes in both normal and impaired livers.
authors.affiliation: Department of Surgery, School of Medicine, Farabi Hospital, Karadeniz Technical University, 61080 Trabzon, Turkey.
authors.forename: Serdar
authors.initials: S
authors.lastname: Topaloglu
authors.affiliation: Department of Nursing, School of Health Sciences, Farabi Hospital, Karadeniz Technical University, 61080 Trabzon, Turkey.
authors.forename: Kıymet
authors.initials: K
authors.lastname: Yesilcicek Calik
authors.affiliation: Department of Surgery, School of Medicine, Farabi Hospital, Karadeniz Technical University, 61080 Trabzon, Turkey.
authors.forename: Adnan
authors.initials: A
authors.lastname: Calik
authors.affiliation: Department of Surgery, School of Medicine, Farabi Hospital, Karadeniz Technical University, 61080 Trabzon, Turkey.
authors.forename: Coskun
authors.initials: C
authors.lastname: Aydın
authors.affiliation: Department of Surgery, School of Medicine, Farabi Hospital, Karadeniz Technical University, 61080 Trabzon, Turkey.
authors.forename: Sema
authors.initials: S
authors.lastname: Kocyigit
authors.affiliation: Department of Biochemistry, School of Medicine, Farabi Hospital, Karadeniz Technical University, 61080 Trabzon, Turkey.
authors.forename: Huseyin
authors.initials: H
authors.lastname: Yaman
authors.affiliation: Department of Anesthesiology, School of Medicine, Farabi Hospital, Karadeniz Technical University, 61080 Trabzon, Turkey.
authors.forename: Dilek
authors.initials: D
authors.lastname: Kutanis
authors.affiliation: Department of Biostatistics, School of Medicine, Hacettepe University, Sıhhiye, 06100 Ankara, Turkey.
authors.forename: Erdem
authors.initials: E
authors.lastname: Karabulut
authors.affiliation: Department of Anesthesiology, School of Medicine, Farabi Hospital, Karadeniz Technical University, 61080 Trabzon, Turkey.
authors.forename: Davut
authors.initials: D
authors.lastname: Dohman
authors.affiliation: Department of Biochemistry, School of Medicine, Farabi Hospital, Karadeniz Technical University, 61080 Trabzon, Turkey.
authors.forename: Asim
authors.initials: A
authors.lastname: Orem
authors.affiliation: Department of Surgery, School of Medicine, Farabi Hospital, Karadeniz Technical University, 61080 Trabzon, Turkey.
authors.forename: Mithat Kerim
authors.initials: MK
authors.lastname: Arslan
mesh_terms: D000328:Adult; D000368:Aged; D002496:Central Venous Pressure; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D007511:Ischemia / Q000473:pathology; D008099:Liver / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies