Simplified Hepatic Resection With the Use of Prolonged Vascular Inflow Occlusion

Terblanche, J.; Krige, J. E. J.; Bornman, P. C.

doi:10.1001/archsurg.1991.01410270038006

Cited by 38 publications

(14 citation statements)

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“…Several types of vascular occlusion have been advocated to reduce operative blood loss and render resectable centrally or near the inferior vena cava (IVC) located tumors [2,[7][8][9][10][11][12][13]. The classic occlusion of the portal triad does not prevent hemorrhage or air embolus from either the IVC or the hepatic veins [5,8,14].…”

Section: Introductionmentioning

confidence: 99%

Total vascular exclusion for liver resections: Pros and cons

Zografos¹,

Kakaviatos²,

Skiathitis³

1999

J. Surg. Oncol.

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Dramatic improvements in morbidity and mortality rates following liver resections have been reported in the past decade. Consequently, the indications for hepatectomy are becoming more liberal. Many techniques of liver resection with or without vascular clamping have been reported with excellent clinical results. Total vascular exclusion (TVE) of the liver during parenchymal transection has been advocated susceptible to increase the resectability of tumors that might not be safely approached by other techniques. Cirrhotic livers are probably more vulnerable to ischemic injury related to TVE than normal livers. The indications and technical and metabolic aspects of the technique are reviewed. J. Surg. Oncol. 1999;72:50–56. © 1999 Wiley‐Liss, Inc.

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Section: Introductionmentioning

confidence: 99%

Total vascular exclusion for liver resections: Pros and cons

Zografos¹,

Kakaviatos²,

Skiathitis³

1999

J. Surg. Oncol.

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“…Huguet et al [4] and Bismuth et al [5] performed hepatectomy in patients with normal liver under contin uous total vascular exclusion (TVE) to reduce operative blood loss resulting in satisfactory outcomes. To minimize liver injury due to ischemia, Terblanche et al [6] and Makuuchi et al [7] proposed a method of repeated inter mittent clamping.…”

Section: Introductionmentioning

confidence: 99%

Experimental Study of Liver Injury after Partial Hepatectomy with Intermittent or Continuous Hepatic Vascular Occlusion

et al. 1995

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The degree of residual liver injury in normal and cirrhotic rats undergoing 70% hepatectomy with hepatic inflow occlusion was examined. The total duration of clamping was 60 min and animals were divided into 3 groups according to the ischemic modality: a 15-min intermittent clamping group (group I); a 30-min intermittent clamping group (group II), and a 60-min continuous clamping group (group III). In normal liver rats, the survival rates after operation in groups I, II and III were 90, 90 and 30%, respectively, compared to 70, 50 and 38%, respectively, in cirrhotic rats. The serum aspartate aminotransferase (AST) level increased markedly with prolongation of each period of clamping in rats with normal liver, showing higher AST levels than those with cirrhotic liver. The liver tissue adenosine-5’-triphosphate (ATP) levels and energy charge (EC) values decreased with prolongation of each period of clamping. Cirrhotic livers showed lower ATP levels and EC values than normal livers. Although there was no significant difference in the mitochondrial function between normal and cirrhotic livers in the group of the same form of ischemia, phosphorylative efficiency of mitochondria was maintained satisfactorily in normal groups I and II and in the cirrhotic group I. Even though cirrhotic livers showed a smaller necrotic response to ischemia than normal livers, they were more vulnerable to ischemia because of an inability to maintain energy metabolism. Therefore, when performing resection of a cirrhotic liver, a 15-min intermittent clamping method should be adopted.

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“…(Bismuth et al, 1989;Habib et al, 1994;Emond et al, 1996;Grazi et al, 1997;Evans et al, 1998;So et al, 1999) Entretanto, nem todos os autores aceitam este parâmetro temporal (Huguet et al, ,1992(Huguet et al, e 1994Delva et al, 1989;Terblanche et al, 1991 ;Hannoun et al, 1993).…”

Section: Tempo De Internação Em Utiunclassified

“…Segundo estes últimos autores, a duração da EVTF que o fígado saudável conseguiria tolerar variaria entre 60 e 120 minutos, havendo, portanto, justificativa para que estes autores adotassem tempo superior a 60 minutos para isquemia hepática (Huguet et al, , 1992(Huguet et al, e 1994Delva et al, 1989;Terblanche et al, 1991 ;Hannoun et al, 1993).…”

Section: Tempo De Internação Em Utiunclassified

“…O limite de 60 minutos, menor do que o adotado por alguns autores, (Huguet et al, , 1992(Huguet et al, e 1994Terblanche et al, 1991 ;Hannoun et al, 1993) foi o utilizado neste estudo, pois a maioria do pacientes 54/81 (67%) recebeu quimioterapia pré-operatória (tabela 1), o que sabidamente é considerado como um fator de risco para a insuficiência hepato-celular no pós-operatório de hepatectomias (Didolkar et al, 1989;Elias et al, 1995b;Rubbia-Brandt et al,2004).…”

Section: Tempo De Internação Em Utiunclassified

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"Perfusão hipotérmica in situ versus exclusão vascular total do fígado para ressecções hepáticas complexas"

Eshkenazy¹

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Simplified Hepatic Resection With the Use of Prolonged Vascular Inflow Occlusion

Cited by 38 publications

References 14 publications

Total vascular exclusion for liver resections: Pros and cons

Total vascular exclusion for liver resections: Pros and cons

Experimental Study of Liver Injury after Partial Hepatectomy with Intermittent or Continuous Hepatic Vascular Occlusion

"Perfusão hipotérmica in situ versus exclusão vascular total do fígado para ressecções hepáticas complexas"

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