Study On The Protection Effect Of Application Of Selective Hepatic Vascular Occlusion Combined With Retrograde Liver Resection In Hepatectomy For Huge Hepatocellar Carcinomas

Objective To evaluate the protection effect of selective hepaticvascular occlusion combined with retrograde liver resection in hepatectomy forhuge hepatocellar carcinomas.Method45patients with huge hepatocellular carcinomas (diameter>10cm) were divided into two groups,according to the clinical Zelen groupingscheme design.One group underwent hepatectomy with total hepatic inflowocclusion and anterograde resection, and another group with selective hepaticvascular occlusion and retrograde resection. two groups were observed in theamount of alanine transaminase, total bilirubin and prealbumin at1weeks afteroperation. Apoptosis index, calcium ion concentration, malondialdehyde andsuperoxide dismutase were deteced in the remaining liver after operation.Resluts Compared to the group underwent hepatectomy with totalhepatic inflow occlusion and anterograde resection,the group with selective hepatic vascular occlusion and retrograde resection had lower alaninetransaminase concentration，and higher prealbumin level at1weeks afteroperation，the difference was statistically significant (P<0.05). The remaininghepatic cell Apoptosis index, calcium ion concentration, malondialdehydecontent significantly decreased, superoxide dismutase levels increased, thedifferences were statistically significant also (P<0.05).Conclusion Compared with conventional procedure, anteriorapproach hepatectomy with selective inflow occlusion for huge HCC is superiorin reducing reperfusion injury of the contralateral non-tumor liver tissue andimproving the function of remnant liver.