Is radical hepatic surgery safe?

Brancatisano, R.; Isla, Alberto; Habib, Nagy

doi:10.1016/s0002-9610(97)00265-1

Cited by 53 publications

(39 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The frequency of perihepatic infected fluid collections has been reported to be 2 % to 20 %, biliary fistulas occurrence was up to 8 % of patients [18] . Brancatisano showed similar perioperative mortality (2.5 %) in radical major hepatic surgery by TVE but with a lower postoperative complication rate (about 46 %) than that of ours [19] . At present, it is generally accepted that liver resection performed under intermittent warm ischema is a safe and well-tolerated modality in patients with and without cirrhotic livers [20] .…”

Section: Discussionsupporting

confidence: 66%

Total vascular exclusion technique for resection of hepatocellular carcinoma

Yin

Wang²,

Yu³

et al. 2003

WJG

View full text Add to dashboard Cite

AIM:To improve the low resection rate, poor prognosis and to control the massive hemorrhage during operation, total vascular exclusion (TVE) technique was used in hepatectomies of advanced and complicated hepatocellular carcinomas (HCCs). METHODS:Five hundred and thirty patients with HCCs were admitted in our hospital. They were divided into TVE technique group (group A: n=78), Pringle maneuver method group (group B: n=176) and unresectable group (group C: n=276). The clinical, operative, pathological parameters and outcome of the patients were statistically evaluated. RESULTS:Group A had a significantly higher resection rate than group B (accounting for 47.92 % and 33.21 % respectively). There was no significant difference in blood loss, blood transfusion and perioperative mortality between groups A and B. Both groups had the similar median disease free survival time (14.6 vs 16.3 months) and 1 year survival rate (92.9 % vs 95.5 %). The TVE group had a medial survival time of 40.5 months and its 5-year survival rate was 34.6 %. CONCLUSION:As compared with Pringle maneuver method, the total vascular exclusion is a safe and effective technique to increase the total resection rate of advanced and complicated HCCs.

show abstract

Section: Discussionsupporting

confidence: 66%

Total vascular exclusion technique for resection of hepatocellular carcinoma

Yin

Wang²,

Yu³

et al. 2003

WJG

View full text Add to dashboard Cite

show abstract

“…[85][86][87][88][89] These statistics cannot be directly applied to healthy donors, but they raise appropriate concern. Left lateral segment resection is sufficiently safe, but relatively few extensive resections have been performed in this population.…”

Section: Resection Optionsmentioning

confidence: 99%

“…There is a great deal of variability between studies, but liver failure is the immediate cause of 40% to 80% of deaths after major hepatic resection, 85,87,89 and cirrhosis and extensive resections are frequently associated. 85,[87][88][89] Several recent studies including large numbers of patients failed to show an association between the extent of resection and morbidity and mortality, 85,90 probably reflecting the appropriate exclusion of those at high risk. In a series of patients with positive hepatitis serological results, liver failure did not occur in any patient with a remnant liver volume greater than 250 mL.…”

Section: Resection Optionsmentioning

confidence: 99%

Right lobe living donor liver transplantation: A review

Marcos

2000

Liver Transpl

157

View full text Add to dashboard Cite

The continuing shortage of organs for adult transplant recipients has generated enthusiasm for adult-to-adult living donor liver transplantation (LDLT). The major concern has been the ability to resect a graft of adequate size without subjecting the donor to undue risk. The right hepatic lobe is generally large enough for adult recipients, but because of the real and perceived risks of right lobe (RL) resection, surgeons have been hesitant to offer this option to their patients. The first series of RL resections that included a significant number of patients was reported in 1999, and the results were encouraging. Only minor complications occurred in donors, and the recipients fared quite well. Enthusiasm for these donor resections is growing, and more centers are beginning to perform them. There is a good deal of global experience with pediatric LDLT but little with adults, and there are unique considerations in this population. This review examines donor selection criteria for adult recipients, highlights technical points critical for good outcome, and examines the early results and complications in both donors and recipients. If the preliminary results continue to be reproduced, RL LDLT could have significant impact on the worsening organ shortage.

show abstract

“…In the vast majority of hepatectomies aminotransferase elevations are described on a temporary basis, returning to normal levels by the end of a few days, a fact observed in these cases. Even in patients who underwent resections without vascular clamping without bleeding these enzymes show an increase in their baseline values, demonstrating that the surgical impact on the liver may be your main driver, and do not represent degree of functional impairment 1,2,6 . The authors' impression is that the necrosis obtained with the method is not primarily responsible for the elevated transaminases, since, regardless of the size of the resection, the change in liver function tests, postoperative, was similar.…”

Section: Discussionmentioning

confidence: 99%

É possível diminuir o sangramento em hepatectomias sem a realização de exclusão vascular total ou parcial?: Resultados do uso de radiofrequência bipolar com agulhas resfriadas

Sampaio¹,

Waechter²,

Passarin³

et al. 2011

ABCD, arq. bras. cir. dig.

View full text Add to dashboard Cite

RACIONAL: Embora a ressecção seja ainda o procedimento de escolha no tratamento curativo das lesões malignas do fígado, o sangramento permanece como fator de morbidade com grande impacto na cirurgia hepática. Com o intuito de minimizar esta complicação, diversas opções tecnológicas têm sido utilizadas, entre elas mais recentemente a radiofrequência, permitindo que o procedimento seja realizado com incisões menores, sem necessidade de clampeamento vascular, com mínima dissecção hepática, ou sangramento. OBJETIVO: Apresentar os resultados em uma série de pacientes utilizando nova técnica de ressecção do parênquima hepático através de agulhas paralelas de radiofrequência bipolar desenvolvidas pelos próprios autores, verificando o impacto no sangramento trans-operatório dos pacientes submetidos à hepatectomias. MÉTODOS: Sessenta pacientes foram submetidos à ressecção hepática através do uso da radiofrequência bipolar. O sangramento per-operatório foi avaliado através da medição do volume coletado em aspirador e pela diferença de peso nas compressas utilizadas durante o procedimento. Todos os casos foram acompanhados em sua função hepatocitária através de exames laboratoriais durante a primeira semana de pós-operatório. RESULTADOS: As ressecções hepáticas foram realizadas com média de 87 minutos, tamanho médio da incisão abdominal de 14 cm e sangramento médio de 58 mililitros. Nenhum paciente recebeu transfusão de sangue ou derivados. Não foram utilizados cateteres venosos centrais. Todos pacientes obtiveram rápida recuperação anestésica, obtendo alta da sala de recuperação para a enfermaria em menos de 12 horas. A drenagem pós-operatória foi anotada até a retirada do dreno abdominal em todos os pacientes. O tempo de internação hospitalar médio foi de 3,2 dias. Após um pico de elevação das provas de função hepática nos primeiros três dias, todos apresentaram retorno destes exames aos parâmetros pré-operatórios ao final do 1o mês. CONCLUSÃO: É possível, factível e válida a utilização de agulhas de radiofrequência para a realização de hepatectomias, mesmo maiores, reduzindo o sangramento.

show abstract

Is radical hepatic surgery safe?

Cited by 53 publications

References 8 publications

Total vascular exclusion technique for resection of hepatocellular carcinoma

Total vascular exclusion technique for resection of hepatocellular carcinoma

Right lobe living donor liver transplantation: A review

É possível diminuir o sangramento em hepatectomias sem a realização de exclusão vascular total ou parcial?: Resultados do uso de radiofrequência bipolar com agulhas resfriadas

Contact Info

Product

Resources

About