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Central hepatectomy under sequential hemihepatic control.
Arkadopoulos, Nikolaos; Kyriazi, Maria A; Theodoraki, Kassiani; Vassiliou, Pantelis; Perelas, Apostolos; Vassiliou, Ioannis; Smyrniotis, Vassilios.
Afiliação
  • Arkadopoulos N; 4th Department of Surgery, Athens University School of Medicine, Attikon University Hospital, 17 Efpatorias str., 11522, Athens, Greece.
Langenbecks Arch Surg ; 397(8): 1283-8, 2012 Dec.
Article em En | MEDLINE | ID: mdl-23011293
PURPOSE: Central hepatectomy is a complex, parenchymal-sparing procedure which has been associated with increased blood loss, prolonged operating time, and increased duration of remnant hypoxia. In this report, we compare two different techniques of vascular control, namely sequential hemihepatic vascular control (SHHVC) and selective hepatic vascular exclusion (SHVE) in central hepatectomies. METHODS: From January 2000 to September 2011, 36 consecutive patients underwent a central hepatectomy. SVHE was applied in 16 consecutive patients, and SHHVC was applied in 20 patients. Both groups were comparable regarding their demographics. RESULTS: Total operative time and morbidity rates were similar in both groups. Warm ischemia time was significantly longer in SVHE patients (46 min vs 28 min, p = 0.03). Total blood loss and number of transfusions per patient were also higher in the SVHE group (650 vs. 400 mL, p = 0.04 and 2.2 vs. 1.2 units, p = 0.04, respectively). AST values were significantly higher in SVHE on days 1 and 3 compared to SHHVC patients (650 vs. 400, p = 0.04 and 550 vs. 250, p = 0.001, respectively). CONCLUSION: Sequential hemihepatic vascular control is a safe technique for central hepatectomies. Decreased intraoperative blood loss and transfusions and attenuated liver injury are the main advantages of this approach.
Assuntos

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Procedimentos Cirúrgicos Vasculares / Perda Sanguínea Cirúrgica / Hepatectomia / Fígado / Neoplasias Hepáticas Limite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2012 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Procedimentos Cirúrgicos Vasculares / Perda Sanguínea Cirúrgica / Hepatectomia / Fígado / Neoplasias Hepáticas Limite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2012 Tipo de documento: Article