The Half Liver Vascular Occlusion And The Effect Of Hepatic Portal Blood Flow Occlusion (pringle, France) In Liver Cancer Surgery

BACKGROUND:Although there are many ways to treat primary hepatocellular carcinoma(HCC),early surgical resection is still the most effective.Control of blood loss is a crucial problem during hepatectomy. It is mainly the occlusion of the inflow and outflow of the porta hepatis to prevent bleeding of the hepatic veins.Several occlusion techniques are frequently used.They are vascular inflow occlusion(Pringle maneuver), hemihepatic vascular occlusion and total hepatic vascular exclusion (THVE).Pringle maneuver and THVE give rise to ischemia-reperfusion injuries which exerts direct impact on patients' treatment effect,recovery and the occurrence of complications.Yet hemihepatic vascular occlusion selectively interrupts the blood flow of the diseased side of the liver,thus its damage to hepatic function is comparatively slight,and the death rate and the occurrence of complications are decreased.Taking two teams of HCC patients who have had liver resection by Pringle maneuver and hemihepatic vascular occlusion respectively as examples,this thesis attempts to find out the advantages and disadvantages of Pringle maneuver and hemihepatic vascular occlusion by comparing their surgical ischemic time,blood loss,postoperative liver function and complications,and so on.Therefore,the author hopes the research result could give guidance for clinic practice. OBJECTIVE:To study the application and efficacy of hemihepatic vascular occlusion in HCC resection.METHODS:Firstly,choose 90 cases of HCC patients and divide them into two groups.Secondly,perform liver resection by Pringle maneuver and hemihepatic vascular occlusion respectively.Thirdly, observe their ischemia time,operative time,blood loss,postoperative liver function,the occurrence of complications and the recovery of gastro-intestinal function etc.Fourthly,analyze the enumeration data by x~2 test and measurement data by t-test,and differentiate the independent impact factor of postoperative complications by multivariate analysis. Finally,comparatively study the efficacy of the two occlusions.RESULTS:There is not significant difference between hemihepatic vascular occlusion and Pringle maneuver in ischemia time,operative time, blood loss(P＞0.05).However,in postoperative liver function,the occurrence of complications,intestinal function recovery time etc.,there are significant difference.The former is significantly superior to the latter. (P＜0.05)CONCLUSION:The hemihepatic vascular occlusion team is slightly higher than Pringle maneuver team in ischemia time,operative time,blood loss,but there has no significant difference.By comparison,it manifests that the hemihepatic vascular occlusion team has less impact on liver function,lower rate of occurrence of complications and faster recovery speed.Therefore,the thesis concludes that the hemihepatic vascular occlusion is better than Pringle maneuver in hepatic inflow occlusion in HCC surgery.