Aortic occlusion and vascular isolation allowing avascular hepatic resection
M. S. Stephen, A. G. Sheil, J. F. Thompson, T. Wilson and S. L. Boland
Department of Surgery, Royal Prince Alfred Hospital, Australia.
Occlusion of the supraceliac abdominal aorta and hepatic vascular isolation
were employed in a series of 15 patients as a definitive method to allow
avascular hepatic resection. The series was compared with an earlier group
of patients treated conventionally. In the avascular hepatic resection
group there was no mortality; hypotension did not occur at the time of
hepatic vascular isolation; rapid, accurate excision of the hepatic lesions
could be achieved in a bloodless field; resection of midline lesions and
those involving the great veins was possible; and "segmentectomies," or
resections crossing segmental boundaries, could be performed where
previously formal hepatic lobectomies were required. Concomitantly, the
greatest amount of uninvolved hepatic parenchyma remained in situ. There
was increased ease of operative management, reduced blood loss, and reduced
operating time (mean, 2.8 hours).
