SUITABLE VASCULAR CLAMPING DURING HEPATECTOMY INVOLVING 1 OR FEWER SECTORS

• Published in: Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) Vol. 64; no. 1; pp. 24 - 30
• Main Authors: TANAKA, Kuniya, MATSUO, Kenichi, SAITO, Shuji, NAGANO, Yasuhiko, FUJII, Yoshiro, ENDO, Itaru, SEKIDO, Hitoshi, TOGO, Shinji, SHIMADA, Hiroshi
• Format: Journal Article
• Language: English
• Published: Japan Surgical Association 2003
• ISSN: 1345-2843; 1882-5133
• DOI: 10.3919/jjsa.64.24

To clarify suitable clamping during hepatectomy, we compared feasibly and morbidity in patients with liver resection involving 1 or fewer sectors. Subjects numbering 100 were divided into 3 groups based on hepatic clamping, i. e., nonclamping (N), Pringle's maneuver (P), and selective clamping (S). Clamping of 15 minutes followed by 5 minutes of release was conducted in the P and S groups. In patients with chronic hepatitis or liver cirrhosis, postoperative transaminase was lowest in the N group, but no significant differences in feasibility or morbidity were seen between the P and S groups. In normal liver patients, the duration of hepatectomy, resected liver volume, and cut surface area were greater in the S group than that in P group, while the postoperative decrease in platelet count and increase in serum bilirubin were greater in the P group (P<0.05). Based on these results, we concluded that no difference existed in postoperative feasibility and morbidity between Pringle's maneuver and selective clamping in patients with chronic hepatitis or liver cirrhosis, indicating Pringle's maneuver should be actively performed. In contrast, selective clamping is suitable for patients with normal liver for improving feasibility and avoiding certain complications.