Application of right hemihepatic blood flow occlusion in anatomical right posterior lobectomy
10.3877/cma.j.issn.2095-3232.2016.02.004
- VernacularTitle:右半肝血流阻断在肝右后叶解剖性切除术中的应用
- Author:
Changjun LIU
1
;
Jinhui YANG
;
Weimin YI
;
Xianhai MAO
;
Xianbo SHEN
;
Chuping LIU
;
Xinmin YIN
;
Chuang PENG
;
Meifu CHEN
;
Bo JIANG
;
Jinshu WU
Author Information
1. 湖南省人民医院 湖南师范大学第一附属医院肝胆外科
- Keywords:
Hepatectomy;
Pringle maneuver;
Time;
Blood loss,surgical;
Transaminases
- From:
Chinese Journal of Hepatic Surgery（Electronic Edition）
2016;5(2):77-80
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the application value of right hemihepatic blood flow occlusion in the anatomical right posterior lobectomy. Methods Clinical data of 81 patients undergoing anatomical right posterior lobectomy in Hunan Provincial People's Hospital between January 2010 and February 2015 were retrospectively analyzed. The patients were divided into three groups according to the methods of liver blood lfow occlusion. In the right hemihepatic blood lfow occlusion group (methodⅠgroup), there were 26 cases including 12 males and 14 females with a mean of (48±9) years. In the regional blood flow occlusion of right posterior lobe group (method Ⅱ group), there were 34 cases including 15 males and 19 females with a mean of (48±10) years. In the Pringle's maneuver group (methodⅢgroup),there were 21 cases including 10 males and 11 females with a mean of (48±10) years. The informed consents of all patients were obtained and the local ethical committee approval was received. In methodⅠgroup, the right hepatic pedicle occluding band was prepared for spare, or the right hepatic artery and the right branch of portal vein were dissected and occluded separately. In methodⅡgroup, the right posterior branch of right hepatic artery and the right posterior branch of portal vein were separated, ligated and resected on the basis of methodⅠ. In methodⅢgroup, porta hepatis was not dissected. The operation time, intraoperative hemorrhage volume and blood transfusion were observed in three groups. Clinical data among three groups were compared by one-way ANOVA and LSD-t test. Results The operation time in methodⅠgroup was (168±52) min, which was significantly shorter compared with (216±39) and (193±43) min in method Ⅱ and method Ⅲgroup (LSD-t=-4.093, -1.772; P<0.05). The intraoperative hemorrhage volume in method Ⅰ group was (200±62) ml, which was signiifcantly less compared with (403±38) and (303±37) ml in methodⅡand methodⅢ group (LSD-t=-15.671, -12.735; P<0.05). Conclusion Right hemihepatic blood flow occlusion is a safe and feasible technique for controlling hemorrhage during the anatomical right posterior lobectomy, which signiifcantly decreases the intraoperative hemorrhage volume, shortens operation time and reduces surgical risk.
