The Application Value Of Regional Hepatic Vascular Exclusion In The Hepatectomy

Objective To investigate the application value of regional hepatic vascularexclusion in the hepatectomy. Methods: The clinical data of54patients foranatomical hepatectomy from January2013to January2014were retrospectivelyanalyzed. They were assigned to two groups according to different operationaltechniques.24patients received hepatectomy with regional hepatic vascular exclusion(group A). The other30patients received hepatectomy with total hepaticvascular exclusion (group B). The duration of the operation、the timing of hepaticvascular exclusion、intraoperative blood loss、abdominal drainage in24h、liverfunction and CRP status in3days and7days、the incidence of postoperativecomplications and perioperative mortality were compared between the two groups.Results: The operation duration of group A（293.08±104.31）min was significantlylonger than group B（229.37±79.43）min(p<0.05);The time of hepatic vascularexclusion in group A（38.17±15.16）min was significantly longer than groupB(22.4±9.72)min(P<0.05); the intraoperative blood loss of groupA(560.42±145.94)mL was significantly less than group B（741.67±369.54)mL(p<0.05); the abdominal drainage in24h of group A（125.42±81.71mL）was significantly less than group B（251.17±140.48)mL（P<0.05）; The levels of serum ALT（230.38±148.09)U/L，AST（88.79±58.79)U/L，TBIL(33.7±18.19)μmol/L， CRP （108.45±57.52)mg/L of3rdday and ALT（83.71±47.36）U/L，AST（48.17±25.41）U/L，TBIL (16.89±4.96)μmol/L，CRP（41.31±31.07）mg/L in7thday of group A was significantly less than ALT（334.6±183.58）U/L，AST（152.1±63.58）U/L，TBIL (45.26±20.53)μmol/L，CRP（161.2±43.33）mg/L in3rdday and ALT（110.1±41.44）U/L，AST（67.97±28.54） U/L，TBIL (23.84±14.16)μmol/L，CRP（63.8±29.25）mg/L in7thday of group B(p<0.05; the value applies to all comparisons above); the incidence of postoperativecomplications between group A(12.5%) and group B(16.7%) has no statisticalsignificance (p>0.05);both group A and B has no perioperative mortality. Conclusion:The technique of regional hepatic vascular exclusion in the Hepatectomy cansignificantly reduce the intraoperative blood loss and relieve liver damage. It’sadvisable to utilize regional hepatic vascular exclusion as a better way to controlblood loss in the Hepatectomy.