A Prospective Randomized Comparison Of Continuous Hemihepatic With Intermittent Total Hepatic Inflow Occlusion In Hepatectomy For Liver Tumors

Summary Background DataBlood inflow occlusion can reduce blood loss during hepatectomy. However, TH produces ischemic injury to the remnant liver, and is limited in the use by the fact that long time continuous occlusion is not safe, especially in cirrhotic patients. HH technique can reduce the liver ischemia and the severity of visceral congestion.ObjectiveTo evaluate whether continuous hemihepatic inflow occlusion(HH) during hepatectomy can be more safe than and same effective as intermittent total hepatic inflow occlusion(TH) in reducing blood loss.Patients and MethodsFrom November 2001 to March 2006, eighty patients undergoing liver resections were included in a prospective randomized study comparing the intra- and postoperative course under TH(n=40) or HH(n=40). TH was performed with periods of 20 minutes of occlusion and 5 minutes of releasing, while HH with continuous occlusion. The surface area of liver transection was measured and blood loss during transection per square centimeter of...