Objective: To investigate the experience and some re-lated problems of non-bleeding technique in partialhepatectomy.Methods: 49 cases of hepatic tumors were reviewed,including 41cases of hepatic carcinoma, 3 cases of ...Objective: To investigate the experience and some re-lated problems of non-bleeding technique in partialhepatectomy.Methods: 49 cases of hepatic tumors were reviewed,including 41cases of hepatic carcinoma, 3 cases of sec-ondary hepatic carcinoma, 4 cases of haemangioma,and 1 case of hepatic adenoma. Three kinds of bleed-ing control technique including normothermic com-plete hepatic vascular exclusion (47/49), completevascular isolation with hypothermic perfusion (1/49),and partial extracorporeal hepatectomy (1/49) wereemployed.Results: The intraoperative volume of blood loss was1560±1252ml, and operative duration was 4.7±0.8h. One case died perioperatively because of severebleeding. 31 cases of primary hepatic carcinoma werefollowed up; the 0.5-, 1-, and 5-year survival rateswere 77% (24/31), 55% (17/31), and 36% (11/31)respectively.Conclusions: In liver surgery concerning hepatoma inthe segment of Couinaud Ⅰ, Ⅳ, Ⅴ or Ⅷ, Pringle'sprocedure is still the major method for bleeding con-trol. When the vena cava or/and venae hepaticaewas/were implicated, normothermic complete hepaticvascular exclusion is helpful. The partial extracorpo-real technique can provide a good exposure to the ca-va inferior, and is an alternative to the complete ex-tracorporeal method. Intraoperative B ultrasound de-tection plays an important role in choosing bleedingcontrol technique.展开更多
文摘Objective: To investigate the experience and some re-lated problems of non-bleeding technique in partialhepatectomy.Methods: 49 cases of hepatic tumors were reviewed,including 41cases of hepatic carcinoma, 3 cases of sec-ondary hepatic carcinoma, 4 cases of haemangioma,and 1 case of hepatic adenoma. Three kinds of bleed-ing control technique including normothermic com-plete hepatic vascular exclusion (47/49), completevascular isolation with hypothermic perfusion (1/49),and partial extracorporeal hepatectomy (1/49) wereemployed.Results: The intraoperative volume of blood loss was1560±1252ml, and operative duration was 4.7±0.8h. One case died perioperatively because of severebleeding. 31 cases of primary hepatic carcinoma werefollowed up; the 0.5-, 1-, and 5-year survival rateswere 77% (24/31), 55% (17/31), and 36% (11/31)respectively.Conclusions: In liver surgery concerning hepatoma inthe segment of Couinaud Ⅰ, Ⅳ, Ⅴ or Ⅷ, Pringle'sprocedure is still the major method for bleeding con-trol. When the vena cava or/and venae hepaticaewas/were implicated, normothermic complete hepaticvascular exclusion is helpful. The partial extracorpo-real technique can provide a good exposure to the ca-va inferior, and is an alternative to the complete ex-tracorporeal method. Intraoperative B ultrasound de-tection plays an important role in choosing bleedingcontrol technique.
