Selective Glissonean Pedicle Exclusion In The Hepatic Resection

Objective:To valuate different clinical effects of three inflow occlusion methods in hepatectomy including selective Glissonean pedicle exclusion,pringle maneuver and selective portal venous exclusion .Methods: A retrospective study was used, collecting 229 cases with the liver resection including hemihepatectomy,hepatic lobectomy and segmentectomy ,all of which were from 2005 to 2009 in the Affiliated Union Hospital of Fujian Medical University. Among them, the selective Glissonean pedicle exclusion group included 96 cases , while the pringle maneuver group had 113 cases and the selective portal venous exclusion group had 20 cases. The amount of intraoperative blood loss,blood transfusion ,operative time,warm ischemia time,hepatic function and complications were compared for each group .Results: The amount of hemorrhage and transfusion required in SGSE group were less than that of P group(P<0.05).The SGSE group showed lower level of ALT in the first,third and seventh postoperative day than P group, with statistical difference .It costed less time in SGSE group for liver function such as ALT,AST,Tbil returning to normal level.And SGSE group costed less time in the recovery?of gastrointestinal function after operation than SPVE group and P group .The SGSE group showed less complications and shorter postoperative stays than P group with significant difference .Conclusion: Selective Glissonean pedicle exclusion is effective both in controlling blood loss and blood transfusion rate during liver resection, and reducing the incidence of postoperative complications. Associated with better postoperative liver function, it is a safe, effective and feasible method of hepatic blood exclusion.