title: The Advantages and Disadvantages of Methods Used to Control Liver Bleeding: A Review.
abstract: BACKGROUND
  Despite advancements in the science of surgery, minimizing bleeding from parenchymal tissue of the liver continues to be one of the challenges surgeons are facing to protect patients' lives. However, the number of surgeries needing incisions in the liver tissue, e.g. metastatectomy, is constantly increasing.
  
  
  METHODS
  A MEDLINE and conventional search of the past 50 years of the medical literature was performed to identify relevant articles on hemostasis in the liver parenchymal tissue.
  
  
  RESULTS
  The studies that have been published on hemostasis in the liver parenchymal tissue can be classified into 3 categories: 1. surgical procedures; 2. methods affecting body hemodynamic; 3. pharmacological methods. The purpose of these studies are to identify the best therapeutic approaches that not only minimize the bleeding, but also save the maximum amount of the liver tissue and minimize the use of partial liver resections.
  
  
  CONCLUSIONS
  The excessive blood loss and the long time needed to control the bleeding during liver surgery impose several side effects and complications on patients. Topical hemostatic agents such as ferric chloride, potassium aluminum sulfate (alum) and aluminum chloride are safely applicable in patients. These agents might be used along with other current methods to minimize the blood loss and the need for blood products during liver surgeries.
authors.affiliation: Department of Neurology, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
authors.forename: Saeed
authors.initials: S
authors.lastname: Nouri
authors.affiliation: Trauma Research Center, Kashan University of Medical Sciences, Kashan, IR Iran.
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Sharif
authors.affiliation: Trauma Research Center, Kashan University of Medical Sciences, Kashan, IR Iran.
authors.forename: Hasan
authors.initials: H
authors.lastname: Afzali
authors.affiliation: Trauma Research Center, Kashan University of Medical Sciences, Kashan, IR Iran.
authors.forename: Alireza
authors.initials: A
authors.lastname: Sharif
authors.affiliation: Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran.
authors.forename: Mojtaba
authors.initials: M
authors.lastname: Satkin
keywords: Hemodynamic; Liver; Pharmacology; Surgical Procedures
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