The Application Of Glissonean Pedicle Transaction Method Associated With Control Of Hepatic Veins Technique For Hepatocelluar Carcinoma

At present, the treatment of hepatocelluar carcinoma(HCC) is still a comprehensive method based on surgical resection, surgical resection is still the most effective treatment[1]. But the liver had a complex anatomical structure, abundant blood supply.Meanwhile,it played a very important physiological role in human’s life.So,how to control the postoperative haemorrhage, complications and improve the prognosis becomes the key point.Pringle method as the traditional hepatc inflow exclusion[2] is the classic method of controlling bleeding during hepatectomy[3-4].But it could casue ischemia reperfusion injury which may lead to liver failure after operation. Since 1990 s, Japanese scientists Takasaki [5], According to the new method of division of hepatic segments, the Glissonean pedicle transaction method was proposed. However, there are some defects in the Glisson pedicle transection method. In recent years, there have been many applications of the method of combining hepatic vein occlusion. This method is simple and rapid, and has little effect on the liver. Therefore, by comparing the two types of surgery is conducive to the clinical choice of related diseases.Objective:To explore the clinical significance of Glisson pedicle transection method and Pringle method in surgical resection of hepatocellular carcinoma.Materials and Methods:It was a retrospective analyzed that the clinical data of 50 patients who underwent surgical resection for HCC in No.1 Hospital of Jilin University from 2013-4 to 2015-12. The patients were divided into two groups, A and B. Group A(25 cases), used Glisson pedicle transection method associated with control of hepatic veins,and group B(25 cases) was Pringle method. The amount of Intraoperative haemorrhage, rate of blood transfusion, operative time, postoperative(1D, 3D,7D), serum total bilirubin(TB), alanine amino transferase(ALT), aspartic aspartate aminotransferase(AST), postoperation complications,(biliary fistula, bleeding, ascites),hospitalization time were compared for each group.Results:Group A with Intraoperative haemorrhage, intraoperative blood transfusion rate was significantly less than the group B. Group A postoperative liver function(ALT, AST, TB) was significantly lower than the level of group.B. The incidence of surgical complications(biliary fistula, bleeding, abdominal effusion) in group Awas significantly lower than that in group B. The average hospitalization in group A was significantly shorter than that in group B.Conclusion:Glissonean pedicle transection method can effectively reduce intraoperative hemorrhage and transfusion rate, the incidence of complications, and shorten the hospitalization time.It is an effective, fast, safe surgical technique.