A Prospective Randomized Comparison of Continuous Hemihepatic with Intermittent Total Hepatic Inflow Occlusion in Hepatectomy for Liver Tumors

作者：Liang, Guanlin; Wen, Tianfu^*; Yan, Lunan; Bo Li; Wu, Guochang; Yang, Jian; Lu, Bo; Chen, Zheyu; Liao, Zhixue; Ran, Shun; Yu, Zhang

来源：Hepato-Gastroenterology, 2009, 56(91-92): 745-750.

• Hemihepatic inflow occlusion
• Pringle's maneuver
• Hepatectomy
• Liver neoplasm

Background/Aims: To evaluate whether continuous hemiliepatic inflow occlusion (HHO) during hepatectomy can be safer than and be as effective as intermittent total hepatic inflow occlusion (THO) in reducing blood loss. @@@ Methodology: Eighty patients undergoing liver resections were included in a prospective randomized study comparing the intra- and postoperative course under THO (n=40) or HHO (n=40). THO was performed with periods of 20 minutes of occlusion and 5 minutes of releasing, while HHO was performed with continuous occlusion. The surface area of liver transection, amount of blood loss, measurements of alanine aminotransferase (ALT) and aspartate aminotransferase (AST), and postoperative evolution were recorded. @@@ Results: The two groups were similar at entry in terms of preoperative liver function and in the proportion of patients experiencing major hepatectomy. The total ischemic time of the two groups was similar (p=0.37), but the operative time in the THO group was longer than in the HHO group (p=0.02). No significant difference was found between the HHO and THO group in blood loss during liver parenchyma transection (p=0.14), the elevations of ALT and AST on the first postoperative day (ALT: p=0.12; AST: p=0.66) and postoperative morbidity (p=0.35). @@@ Conclusions: On the basis of our findings, if it is feasible, continuous HHO is recommended for complex liver resection.

• 出版日期2009-5
• 单位四川大学