Application of hemihepatic vascular occlusion with hanging maneuver in hepatectomy

Division of Hepatobiliary Disease, Department of General Surgery Second Xiangya Hospital of Central South University, Changsha 410011, China.
Hepato-gastroenterology (Impact Factor: 0.93). 03/2009; 56(90):442-6.
Source: PubMed


To evaluate the hemihepatic vascular occlusion with hanging maneuver in hepatectomy.
Ninety-four cases of hepatectomy were analyzed retrospectively. All patients were randomized into 3 groups: Pringle maneuver was applied in Group 1 (n=40), hemihepatic inflow control was Group 2 (n=30) and complete hemihepatic vascular occlusion with hanging maneuver was applied in Group 3 (n=24).The clamping period, operation time, bleeding volume, blood transfusion volume, postoperative recovery of liver function and postoperative complications were compared among three groups.
The average times of clamping in Group 1 was 1.6 +/- 0.7, but only one clamping in Group 2 and 3. There were significant differences among three groups in bleeding volume as well. The postoperative serum ALT and total bilirubin (TBIL) in Group 2 and 3 were significantly lower than those of Group 1.5 patients died of liver failure after operation in Group 1. But liver failure or morbidity wasn't happened in Group 2 and 3. The rates of biliary leakage in Group 1 and 2 were more than that of Group 3. The hospitalization duration of Group 1 was significantly longer than those of Group 2 and 3.
Hemihepatic vascular occlusion with hanging maneuver, which can reduce bleeding volume and enhance the recovery of liver function, is safe and practicable, especially for patients with liver cirrhosis.

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