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- Title
Techniques of Hepatectomy for Hepatocellular Carcinoma.
- Authors
Nagasue, Naofumi; Hayashi, Takafumi; Uchida, Masaaki
- Abstract
Intraoperative blood loss is well associated with the immediate outcome after hepatic resection particularly in cirrhotic patients. Temporary occlusion of the hepatic inflow (Pringle's maneuver) effectively suppresses the blood loss and postoperative mortality. This technique is safe for 60-70 min in noncirrhotic and for 30 min in cirrhotic patients. Total vascular exclusion of the liver is rarely indicated but useful in resecting tumors adjacent to or growing in the main hepatic veins or inferior vena cava. Hypothermia may be used when the ischemic time is longer than the above-mentioned times. Extrahepatic control of the hepatic veins is possible in most cases. A Cavitron ultrasonic surgical aspirator is widely used to transect noncirrhotic livers but without diminishing blood loss. Autotransplantation of the liver with bench procedures may be indicated for only very selected patients. Although it is still controversial to place or not to place drains after hepatic resection, a routine drainage is probably not necessary. Copyright © 1995 S. Karger AG, Basel
- Publication
Digestive Surgery, 1995, Vol 12, Issue 1, p34
- ISSN
0253-4886
- Publication type
Article
- DOI
10.1159/000172313