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Selective hepatic vascular exclusion for the hepatic resection of HCC. 2007

Eiji Tsujita, and Akinobu Taketomi, and Dai Kitagawa, and Shinji Itoh, and Norifumi Harimoto, and Tomonobu Gion, and Shunji Kohnoe, and Yoshihiko Maehara
Department of Medicine, Fukuoka Dental College, Japan. tsujita@college.fdcnet.ac.jp

OBJECTIVE Selective hepatic vascular exclusion (SHVE) is an effective technique for the control of bleeding in major hepatic resections. Outcomes of the procedures of the SHVE group were compared with the non-SHVE group. METHODS A retrospective study was carried out of 312 hepatic resections performed over a period of 10 years. The cases in this study were limited to Child's classification A, because of the rate of Child A in the SHVE group (n=82) was significantly higher than that within the non-SHVE group (n=158) (93% vs. 71%; p < 0.001). Preoperative factors, like age, gender, tumor size, intraoperative blood loss, operation time, and the postoperative course of the two groups were compared for both groups. RESULTS The SHVE group showed significantly less blood loss, necessary blood transfusion, and a significant rate of severe postoperative complications. The rate of segmentectomy and subsegmentectomy in the SHVE group was higher than in the non-SHVE group, and the rate of partial hepatectomy and lobectomy in the non-SHVE group was higher than that in the SHVE group. Although the more difficult operations were performed in the SHVE group than in the non-SHVE group, there was no significant difference in the postoperative hospital stays in both groups. CONCLUSIONS The SHVE technique is effective for bleeding control in major liver resections.

UI MeSH Term Description Entries
D008099 Liver A large lobed glandular organ in the abdomen of vertebrates that is responsible for detoxification, metabolism, synthesis and storage of various substances. Livers
D008111 Liver Function Tests Blood tests that are used to evaluate how well a patient's liver is working and also to help diagnose liver conditions. Function Test, Liver,Function Tests, Liver,Liver Function Test,Test, Liver Function,Tests, Liver Function
D008113 Liver Neoplasms Tumors or cancer of the LIVER. Cancer of Liver,Hepatic Cancer,Liver Cancer,Cancer of the Liver,Cancer, Hepatocellular,Hepatic Neoplasms,Hepatocellular Cancer,Neoplasms, Hepatic,Neoplasms, Liver,Cancer, Hepatic,Cancer, Liver,Cancers, Hepatic,Cancers, Hepatocellular,Cancers, Liver,Hepatic Cancers,Hepatic Neoplasm,Hepatocellular Cancers,Liver Cancers,Liver Neoplasm,Neoplasm, Hepatic,Neoplasm, Liver
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D010043 Outcome and Process Assessment, Health Care Evaluation procedures that focus on both the outcome or status (OUTCOMES ASSESSMENT) of the patient at the end of an episode of care - presence of symptoms, level of activity, and mortality; and the process (ASSESSMENT, PROCESS) - what is done for the patient diagnostically and therapeutically. Outcome and Process Assessment (Health Care),Donabedian Model,Donabedian Triad,Outcome and Process Assessment,Structure Process Outcome Triad,Model, Donabedian,Triad, Donabedian
D011183 Postoperative Complications Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D001803 Blood Transfusion The introduction of whole blood or blood component directly into the blood stream. (Dorland, 27th ed) Blood Transfusions,Transfusion, Blood,Transfusions, Blood
D005260 Female Females
D006498 Hepatectomy Excision of all or part of the liver. (Dorland, 28th ed) Hepatectomies

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