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A Biological Study of 20 Patients Submitted to Extensive Hepatectomy

Claude Huguet, MD; Bernard Nordlinger, MD; Patrick Bloch, MD; Jacqueline Conard

Arch Surg. 1978;113(12):1448-1451.

Abstract
• To evaluate the biological tolerance of the human liver to prolonged warm ischemia, two groups of extensive hepatic resection for tumor were compared. Group 1 (11 patients) performed with short hepatic inflow occlusion (7 [mean] ± 2 [SEM] minutes), and group 2 (nine patients) operated with use of complete hepatic vascular exclusion and prolonged warm liver ischemia (38 [mean] ± 5 [SEM] minutes).

Comparison of biological values, such as transaminase, bilirubin, total protein, albumin, and fibrinogen levels, the platelet count, prothrombin complex, and proaccelerin level, did not show statistically significant differences between the two groups. Therefore, the hepatic warm ischemia period may be, if needed, safely extended beyond the classical 15 minutes. It lasted 65 minutes in one case without adverse effect. These clinical observations parallel recent experimental work and should destroy the myth of the high sensitivity of the liver to warm ischemia.

(Arch Surg 113:1448-1451, 1978)

Author Affiliations
From the Department of Digestive Surgery, Hospital Saint Antoine, Paris. Dr Nordlinger is now with the Emory University Hospital, Atlanta.

Footnotes
Accepted for publication May 4, 1978.

Reprint requests to Department of Digestive Surgery, Hospital Saint Antoine, 184 Rue de Faubourg Saint Antoine, Paris, France F75012 (Dr Nordlinger).

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