Outcome using selective hemihepatic vascular occlusion and Pringle maneuver for hepatic resection of liver cavernous hemangioma.
BACKGROUND
Though accumulated evidence proved the advantages of laparoscopic hepatectomy, bleeding still remains the most important challenge in clinical practice. Our study aimed to compare the outcomes of Pringle maneuver (PM) and selective hemihepatic vascular occlusion (SHVO) surgeries for patients with liver cavernous hemangioma (LCH).


METHODS
The SHVO (n = 26; mean age, 42) and PM (n = 78; mean age, 43) surgeries were performed in 104 LCH patients from January 2006 to January 2015. The intraoperative (bleeding, arterial pressure, oxyhemoglobin saturation, etc.) and postoperative parameters (anal exhaust time, complications, blood cell numbers, etc.) were measured and compared between the two groups. Liver function of all these patients was detected by blood test at 1-day preoperation, and at 1, 3, and 5 days postoperation.


RESULTS
Both of the two surgeries were successfully performed without any mortality. The intraoperative systolic arterial pressure and pulse in PM group were much higher than that in SHVO group (P < 0.01). The postoperative liver function parameters such as alanine transaminase (ALT), aspartate transaminase (AST), and total bilirubin (TBIL) increased much more in the PM group than that in the SHVO group compared with preoperation results (P < 0.05). However, there were no statistical differences in intraoperative bleeding, blood transfusion, hepatic inflow occlusion time, oxygen saturation occlusion, anal exhaust time and incidence of complications between the two groups (P > 0.05).


CONCLUSIONS
SHVO is safer with less ischemia reperfusion injury than PM surgery for hemangioma resection on patients with LCH.
Hepatobiliary Surgery Department, Ningxia People's Hospital, No.301, North Zhengyuan Street, Jinfeng District, Yinchuan, Ningxia, 750002, China. MinghaoLimhl@163.com.
Minghao
M
Li
Hepatobiliary Surgery Department, Ningxia People's Hospital, No.301, North Zhengyuan Street, Jinfeng District, Yinchuan, Ningxia, 750002, China. chunyanzhangcyz@163.com.
Chunyan
C
Zhang
Hepatobiliary Surgery Department, Ningxia People's Hospital, No.301, North Zhengyuan Street, Jinfeng District, Yinchuan, Ningxia, 750002, China. taozhangtzt@163.com.
Tao
T
Zhang
Hepatobiliary Surgery Department, Ningxia People's Hospital, No.301, North Zhengyuan Street, Jinfeng District, Yinchuan, Ningxia, 750002, China. liyunwanglyw@163.com.
Liyun
L
Wang
Hepatobiliary Surgery Department, Ningxia People's Hospital, No.301, North Zhengyuan Street, Jinfeng District, Yinchuan, Ningxia, 750002, China. yangdingydg@163.com.
Yang
Y
Ding
Hepatobiliary Surgery Department, Ningxia People's Hospital, No.301, North Zhengyuan Street, Jinfeng District, Yinchuan, Ningxia, 750002, China. zhanxueniuzxn@163.com.
Zhanxue
Z
Niu
Hepatobiliary Surgery Department, Ningxia People's Hospital, No.301, North Zhengyuan Street, Jinfeng District, Yinchuan, Ningxia, 750002, China. saiwuheswh@163.com.
Saiwu
S
He
Hepatobiliary Surgery Department, Ningxia People's Hospital, No.301, North Zhengyuan Street, Jinfeng District, Yinchuan, Ningxia, 750002, China. zhiqiyangzqy@163.com.
Zhiqi
Z
Yang
D000328:Adult; D016063:Blood Loss, Surgical / Q000517:prevention & control; D005260:Female; D005500:Follow-Up Studies; D006392:Hemangioma, Cavernous / Q000098:blood supply / Q000473:pathology / Q000601:surgery*; D006498:Hepatectomy; D006801:Humans; D007431:Intraoperative Complications; D008099:Liver / Q000098:blood supply* / Q000473:pathology / Q000601:surgery*; D008113:Liver Neoplasms / Q000098:blood supply / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011183:Postoperative Complications; D011379:Prognosis; D012189:Retrospective Studies