Routine use of total hepatic vascular exclusion in major hepatectomy is not necessary
Farges, O.; Noun, R.; Sauvanet, A.; Jany, S.; Belghiti, J.
Hepato-Gastroenterology 45(20): 370-375
1998
ISSN/ISBN: 0172-6390 PMID: 9638409 Document Number: 484437
The prime concert of a hepato-biliary surgeon undertaking liver resection is to minimize blood loss and prevent air embolism through the control of the major vascular structures. Several methods to achieve this are now available and include in particular clamping of the hepatic pedicle and total vascular exclusion. Both techniques are detailed as well as their benefits and drawbacks. For conventional liver resections, total vascular exclusion has no advantage over clamping of the hepatic pedicle in preventing blood loss and is associated with additional morbidity. This technique should be selectively used in patients with tumours involving major hepatic veins or the inferior vena cava.