Simplified hepatic resection with the use of prolonged vascular inflow occlusion
J. Terblanche, J. E. Krige and P. C. Bornman
Department of Surgery, University of Cape Town, South Africa.
Ten consecutive patients scheduled to undergo liver resection were studied
prospectively with the use of a standard protocol, which included routine
vascular inflow occlusion to reduce blood loss and blood transfusion
requirements. Fibrin sealant was sprayed on the raw liver surface, and
abdominal drainage was not performed. No deaths occurred, and the
postoperative course was remarkably smooth. The normothermic liver ischemic
times of 30 to 122 minutes (mean, 73 minutes) were well tolerated. The
amount of blood transfused was reduced to a mean of 2 U (range, 0 to 4 U).
The occurrence of infected intraabdominal bile collections in two patients
with preexisting biliary tract infection suggested that abdominal drainage
should be performed in such patients. Vascular inflow occlusion is
recommended for all liver resections.
