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Simplified Hepatic Resection With the Use of Prolonged Vascular Inflow Occlusion
John Terblanche, ChM, FCS(SA), FRCS(Eng);
Jake E. J. Krige, FCS(SA), FRCS(Ed);
P. C. Bornman, MMed(Surg), FRCS(Ed)
Arch Surg. 1991;126(3):298-301.
Abstract
• 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.
(Arch Surg. 1991;126:298-301)
Author Affiliations
From the Department of Surgery and the Medical Research Council Liver Research Centre, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa.
Footnotes
Accepted for publication September 29, 1990.
Reprint requests to the Department of Surgery, University of Cape Town Medical School, Observatory 7925, Cape Town, South Africa (Dr Terblanche).
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