A comparative study assessing a new tool for occluding parenchymal blood flow during liver resection for hepatocellular carcinoma

BACKGROUND: The aim of this study was to compare the efficacy of a new tool (the hepatic section vascular blocker, HSVB) with hepatic pedicle clamping and hemihepatic vascular exclusion to control bleeding during liver resection for cancer. METHODS: Clinical data on 117 patients who underwent liver resection from 2004 to 2009 were analysed retrospectively. Forty-two patients had liver resection using the HSVB (group A), in 35 patients hemihepatic vascular exclusion was used (group B), and in 40 patients hepatic pedicle clamping with a Pringle manoeuvre was used (group C). Blood loss, operative time, postoperative hepatic function and complications were compared. RESULTS: Mean blood loss and operative time in group A were significantly less than in groups B (p=0.026 and p<0.001, respectively) and C (p<0.001 and p<0.001). There were significant differences between groups A and C in total bilirubin (TB) and alanine transaminase (ALT) levels on postoperative days 3 and 7, and group A had better hepatic function (TB p=0.014 and p=0.009; ALT p<0.001 and p<0.001). The rate of postoperative ascites was significantly higher in group C compared with group A (p<0.001). In group C, 2 patients had liver failure, 1 had a gastrointestinal haemorrhage and 1 died. CONCLUSIONS: Using the HSVB during liver resection effectively controlled bleeding, saved operative time and preserved hepatic function. It proved to be a safe and feasible technique.

Bibliographic Details

Main Authors:	Zhou,S, Xue,X-J, Li,R-R, Chen,D-F, Chen,W-Y, Liu,G-X, Ke,E-M, Zheng,S-Y
Format:	Digital revista
Language:	English
Published:	Association of Surgeons of South Africa 2013
Online Access:	http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0038-23612013000100003
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