Occlusion of Hepatic Blood Inflow for Complex Central Liver Resections in Cirrhotic Patients
Authors:
- Cheng-Chung WuCWCheng-Chung Wu
- Dah-Cherng YehDYDah-Cherng Yeh
- Wai-Meng HoWHWai-Meng Ho
- Chu-Leng YuCYChu-Leng Yu
- Shao-Bin ChengSCShao-Bin Cheng
- Tse-Jia LiuTLTse-Jia Liu
- Fang-Ku P'ENgFPFang-Ku P'ENg
Open Access
- 1 December 2002
- journal article
- clinical trial
- Published by American Medical Association (AMA) in Archives of Surgery
- Vol. 137 (12) , 1369-1376
Abstract
AT PRESENT, liver resection remains the only treatment option for liver malignacies,1-3 and hemorrhage control remains the main problem in liver resection, especially in patients with cirrhosis.3-6 For effective bleeding control, occlusion of hepatic blood inflow (the Pringle maneuver4) is a valuable procedure.5-15 However, this procedure may result in ischemia-reperfusion injury of hepatocytes.5-10 Despite controversies,8 intermittent occlusion is preferred by most investigators.5,6,9-15 Although the longest time span for occlusion of hepatic blood inflow is not defined, more severe damage of liver function results from longer overall hepatic ischemic times.7,9,13-15 In 1987, Makuuchi et al12 proposed a hemihepatic vascular occlusion technique that reduced the severity of visceral congestion and total liver ischemia. This technique is beneficial for cirrhotic liver resection.12,14Keywords
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