Hemihepatic Vascular Occlusion With Extrahepatic Control Of Major Hepatic Veins In Liver Cancer With Hepatocirrhosis

Objective:To evaluate the significance of hemihepatic vascular occlusion with extrahepatic control of major hepatic veins for hepatectomy in cirrhotic carcinoma h.Materials and Methods:A retrospective comparative study for hepatectomy inpatients with hepatocellular carcinoma (HCC) using Pringle maneuver (groupA n=44), hemihepatic vascular occlusion (group B n=76) and hemihepatic vascular occlusion plus extrahepatic control of major hepatic veins (group C n=85) were made from March2010to September2013. The amount of intraoperative bleeding, time of operation, postoperative liver function, liver function recovering and complications were compared.Results:There was significant difference in the amount of intraoperative blood loss between the three groups (543.7ml、415.8ml、324.5ml, respectively, P<0.001). There was no difference in the time of operation. The level of serum alanine transaminase (ALT) and that of serum bilirubin on the3rd and6th day postopertively in group B, and C was significantly lower than that in group A.Conclusion:Hemihepatic vascular occlusion with control of major hepatic veins results in selective liver isolation from the systemic circulation without interruption of caval flow. It is much more effective than Pringle maneuver for controlling intraoperative bleeding without interruption of hemodynamic stability in liver cancer patient.