Effects of Different Hepatic Inflow Occlusion Methods for Hepatectomy_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

TANG Biao ^1,2 ,  WANG Zhiming. ¹

1. Depar-tment of General Surgery， Xiangya Hospital of Central South University， Changsha 410008， Hunan Province， China;;
2. Department of Hepatobiliary Surgery， Yongzhou Central Hospital， Yongzhou425006， Hunan Province， China;

Corresponding author：

WANG Zhiming., Email: xyawangzhiming@163.com

Keywords：

Hepatic inflow occlusion; Hepatectomy; Operation effect

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Abstract Full text Figures/Tables Video References Cited by

Objective 　To evaluate different clinical effects of three inflow occlusion methods in hepatectomy including pringle maneuver （Pringle group），selective portal venous exclusion （SPVE group）， and Glissonean pedicle exclusion （SGSE group）.
Methods 　The clinical data of patients underwent the liver resection with the above liver inflow occlusion methods were retrospectively analyzed. The operation time， inflow occlusion time， amount of intraop-
erative blood loss， transfusion rate， and postoperative hepatic function and complication rate were compared for each group.
Results 　There were not significant difference of preoperative conditions，operation time， inflow occlusion time，tumor character， postoperative liver function， hospital time，and ICU time （P＞0.05）. The amount of intraoperative blood loss and rate of blood transfusion of SGSE group were significantly less （lower） than those Pringle group and SPVE
group （P＜0.05）. In addition to the first day after operation， the AST and ALT at other time point of SPVE group and SGSE group were improved than that Pringle group （P＜0.05）， while TBIL at the third and fifth day after operation of
Pringle group were improved （P＜0.05）. The complication rates of SPVE group and SGSE group were significantly lower
than that of Pringle group （P＜0.05）.
Conclusions 　In the similar operatin time and inflow occlusion time，Glissonean pedicle exclusion method can control the intraoperative blood loss and blood transfusion better，and can promote the patient
recovery. Besides， the inflow occlusion methods should be selected based on the practical condition of patients.

Citation： TANG Biao,WANG Zhiming.. Effects of Different Hepatic Inflow Occlusion Methods for Hepatectomy. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2013, 20(4): 406-411. doi: Copy

1.	Scatton O， Zalinski S， Jegou D， et al. Randomized clinical trial of ischaemic preconditioning in major liver resection with intermittent Pringle manoeuvre[J]. Br J Surg， 2011， 98(9)： 1236-1243.
2.	Fu SY， Lai EC， Li AJ， et al. Liver resection with selective hepaticvascular exclusion：a cohort study[J]. Ann Surg， 2009， 249(4)：.
3.	Zhou W， Li A， Pan Z， et al. Selective hepatic vascular exclusion and Pringle maneuver：a comparative study in liver resection[J]. Eur J Surg Oncol， 2008， 34(1)：49-54.
4.	Tong Y， Yang JM， Lai EC， et al. Complete hemihepatic vascular exclusion versus pringle maneuver for liver resection：a comparative study[J]. Hepatogastroenterology， 2011， 58(109)：1307-1311.
5.	Machado MA， Makdissi FF， Herman P， et al. Intrahepatic Glissonian approach for pure laparoscopic left hemihepatectomy[J]. J Laparoendosc Adv Surg Tech A，2010， 20(2)：141-142.
6.	Di Giuro G， Lainas P， Franco D，et al. Laparoscopic left hepatectomy with prior vascular control[J]. Surg Endosc， 2010， 24(3)：697-699.
7.	Ishizaki Y， Yoshimoto J， Miwa K， et al. Safety of prolonged intermittent pringle maneuver during hepatic resection[J]. Arch Surg， 2006， 141(7)：649-653.
8.	Tsujita E， Taketomi A， Kitagawa D， et al. Selective hepatic vasc-ular exclusion in hepatic resection of HCC[J]. Hepatogastroenterology，2007， 54(74)：527-530.
9.	Gurusamy KS， Sheth H， Kumar Y， et al. WITHDRAWN： Methods of vascular occlusion for elective liver resections[J]. Cochrane Database Syst Rev， 2009， (1)：CD006409.
10.	Arkadopoulos N， Kostopanagiotou G， Theodoraki K， et al. Isch-emic preconditioning confers antiapoptotic protection during majorhepatectomies performed under combined inflow and outflow exclusion of the liver. A randomized clinical trial[J]. World J Surg， 2009，33(9)：1909-1915.
11.	Clavien PA， Yadav S， Sindram D， et al. Protective effects ofischemic preconditioning for liver resection performed under inflowocclusion in humans[J]. Ann Surg， 2000，232(2)：155-162.
12.	Petrowsky H， McCormack L， Trujillo M， et al. A prospective，randomized，controlled trial comparing intermittent portal triad clamping versus ischemic preconditioning with continuous clampingfor major liver resection[J]. Ann Surg，2006， 244(6)：921-928.
13.	Arkadopoulos N， Kyriazi MA， Theodoraki K， et al. Extrahepatic portal vein ligation in major hepatectomies performed under selective vascular exclusion： a case-control study[J]. Am Surg， 2012，78(3)：300-304.
14.	Pan ZY， Yang Y， Zhou WP， et al. Clinical application of hepatic venous occlusion for hepatectomy[J]. Chin Med J (Engl)， 2008，.
15.	Ishii H， Kobayashi T， Kudou M， et al. Anatomical liver segmentectomy 2 for combined hepatocellular carcinoma and cholangiocarcinoma with tumor thrombus in segment 2 portal branch[J]. World J Surg Oncol， 2012，10：22.
16.	Arkadopoulos N， Stafyla V， Karapanos K， et al. Recurrent pulmonary embolism due to giant hepatic hamangioma treated with hepatectomy under vascular exclusion[J]. Ann Vasc Surg，2010， 24(6)： 827.
17.	De Santis A， Moscatelli R， Catalano C， et al. Systemic thrombolysis of portal vein thrombosis in cirrhotic patients：a pilot study[J]. Dig Liver Dis，2010， 42(6)：451-455.
18.	Takasaki K， Kobayashi S， Tanaka S， et al. Highly anatomicallysystematized hepatic resection with Glissonean sheath code trans-ection at the hepatic hilus[J]. Int Surg， 1990，75(2)：73-77.
19.	Karamarković A， Doklestić K， Milić N， et al. Glissonean pedicleapproach in major liver resections[J]. Hepatogastroenterology， 2012， 59(118)：1896-1901.
20.	Choi J， Lee YJ， Hwang DW， et al. Surgical treatment of giant hepatic hemangiomas： technical point of view[J]. Am Surg， 2011， 77(1)：48-54.
21.	Sadamori H， Matsuda H， Shinoura S， et al. Anatomical subseg-mentectomy in the lateral segment for hepatocellular carcinoma[J]. Hepatogastroenterology，2009，56(94-95)：1511-1515.
22.	Harada K， Masuda T， Beppu T， et al. Hepatic resection using a liver-hanging maneuver and Glissonean pedicle transection for hepatocellular carcinoma in a patient with situs inversus totalis： report of a case[J]. Surg Today， 2012， 42(8)：801-804.
23.	Abu Hilal M， Di Fabio F， Teng MJ， et al. Single-centre compar-ative study of laparoscopic versus open right hepatectomy[J]. J Gastrointest Surg， 2011， 15(5)：818-823.
24.	Lau WY， Lai EC， Lau SH. Methods of vascular control techniqueduring liver resection： a comprehensive review[J]. HepatobiliaryPancreat Dis Int， 2010， 9(5)：473-481.
25.	Ishizaki Y， Yoshimoto J， Miwa K， et al. Safety of prolonged intermittent pringle maneuver during hepatic resection[J]. Arch Surg， 2006， 141(7)：649-653.
26.	Kooby DA， Stockman J， Ben-Porat L， et al. Influence of transfusions on perioperative and long-term outcome in patients following hepatic resection for colorectal metastases[J]. Ann Surg，2003， 237(6)：860-869.
27.	(9)：806-810.
28.	-627.

1. Scatton O， Zalinski S， Jegou D， et al. Randomized clinical trial of ischaemic preconditioning in major liver resection with intermittent Pringle manoeuvre[J]. Br J Surg， 2011， 98(9)： 1236-1243.
2. Fu SY， Lai EC， Li AJ， et al. Liver resection with selective hepaticvascular exclusion：a cohort study[J]. Ann Surg， 2009， 249(4)：.
3. Zhou W， Li A， Pan Z， et al. Selective hepatic vascular exclusion and Pringle maneuver：a comparative study in liver resection[J]. Eur J Surg Oncol， 2008， 34(1)：49-54.
4. Tong Y， Yang JM， Lai EC， et al. Complete hemihepatic vascular exclusion versus pringle maneuver for liver resection：a comparative study[J]. Hepatogastroenterology， 2011， 58(109)：1307-1311.
5. Machado MA， Makdissi FF， Herman P， et al. Intrahepatic Glissonian approach for pure laparoscopic left hemihepatectomy[J]. J Laparoendosc Adv Surg Tech A，2010， 20(2)：141-142.
6. Di Giuro G， Lainas P， Franco D，et al. Laparoscopic left hepatectomy with prior vascular control[J]. Surg Endosc， 2010， 24(3)：697-699.
7. Ishizaki Y， Yoshimoto J， Miwa K， et al. Safety of prolonged intermittent pringle maneuver during hepatic resection[J]. Arch Surg， 2006， 141(7)：649-653.
8. Tsujita E， Taketomi A， Kitagawa D， et al. Selective hepatic vasc-ular exclusion in hepatic resection of HCC[J]. Hepatogastroenterology，2007， 54(74)：527-530.
9. Gurusamy KS， Sheth H， Kumar Y， et al. WITHDRAWN： Methods of vascular occlusion for elective liver resections[J]. Cochrane Database Syst Rev， 2009， (1)：CD006409.
10. Arkadopoulos N， Kostopanagiotou G， Theodoraki K， et al. Isch-emic preconditioning confers antiapoptotic protection during majorhepatectomies performed under combined inflow and outflow exclusion of the liver. A randomized clinical trial[J]. World J Surg， 2009，33(9)：1909-1915.
11. Clavien PA， Yadav S， Sindram D， et al. Protective effects ofischemic preconditioning for liver resection performed under inflowocclusion in humans[J]. Ann Surg， 2000，232(2)：155-162.
12. Petrowsky H， McCormack L， Trujillo M， et al. A prospective，randomized，controlled trial comparing intermittent portal triad clamping versus ischemic preconditioning with continuous clampingfor major liver resection[J]. Ann Surg，2006， 244(6)：921-928.
13. Arkadopoulos N， Kyriazi MA， Theodoraki K， et al. Extrahepatic portal vein ligation in major hepatectomies performed under selective vascular exclusion： a case-control study[J]. Am Surg， 2012，78(3)：300-304.
14. Pan ZY， Yang Y， Zhou WP， et al. Clinical application of hepatic venous occlusion for hepatectomy[J]. Chin Med J (Engl)， 2008，.
15. Ishii H， Kobayashi T， Kudou M， et al. Anatomical liver segmentectomy 2 for combined hepatocellular carcinoma and cholangiocarcinoma with tumor thrombus in segment 2 portal branch[J]. World J Surg Oncol， 2012，10：22.
16. Arkadopoulos N， Stafyla V， Karapanos K， et al. Recurrent pulmonary embolism due to giant hepatic hamangioma treated with hepatectomy under vascular exclusion[J]. Ann Vasc Surg，2010， 24(6)： 827.
17. De Santis A， Moscatelli R， Catalano C， et al. Systemic thrombolysis of portal vein thrombosis in cirrhotic patients：a pilot study[J]. Dig Liver Dis，2010， 42(6)：451-455.
18. Takasaki K， Kobayashi S， Tanaka S， et al. Highly anatomicallysystematized hepatic resection with Glissonean sheath code trans-ection at the hepatic hilus[J]. Int Surg， 1990，75(2)：73-77.
19. Karamarković A， Doklestić K， Milić N， et al. Glissonean pedicleapproach in major liver resections[J]. Hepatogastroenterology， 2012， 59(118)：1896-1901.
20. Choi J， Lee YJ， Hwang DW， et al. Surgical treatment of giant hepatic hemangiomas： technical point of view[J]. Am Surg， 2011， 77(1)：48-54.
21. Sadamori H， Matsuda H， Shinoura S， et al. Anatomical subseg-mentectomy in the lateral segment for hepatocellular carcinoma[J]. Hepatogastroenterology，2009，56(94-95)：1511-1515.
22. Harada K， Masuda T， Beppu T， et al. Hepatic resection using a liver-hanging maneuver and Glissonean pedicle transection for hepatocellular carcinoma in a patient with situs inversus totalis： report of a case[J]. Surg Today， 2012， 42(8)：801-804.
23. Abu Hilal M， Di Fabio F， Teng MJ， et al. Single-centre compar-ative study of laparoscopic versus open right hepatectomy[J]. J Gastrointest Surg， 2011， 15(5)：818-823.
24. Lau WY， Lai EC， Lau SH. Methods of vascular control techniqueduring liver resection： a comprehensive review[J]. HepatobiliaryPancreat Dis Int， 2010， 9(5)：473-481.
25. Ishizaki Y， Yoshimoto J， Miwa K， et al. Safety of prolonged intermittent pringle maneuver during hepatic resection[J]. Arch Surg， 2006， 141(7)：649-653.
26. Kooby DA， Stockman J， Ben-Porat L， et al. Influence of transfusions on perioperative and long-term outcome in patients following hepatic resection for colorectal metastases[J]. Ann Surg，2003， 237(6)：860-869.
27. (9)：806-810.
28. -627.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Effects of Different Hepatic Inflow Occlusion Methods for Hepatectomy

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