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Related Experiment Videos

[Selective and unselective clamping in liver surgery].

K Sano1, T Takayama, M Makuuchi

  • 1Department of Surgery, Graduate School of Medicine, University of Tokyo, Japan.

Nihon Geka Gakkai Zasshi
|July 21, 1999
PubMed
Summary

Reducing operative blood loss during liver surgery is crucial. Both Pringle

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Living related liver transplantation.

Transplantation proceedings·1992

Area of Science:

  • Hepatobiliary Surgery
  • Surgical Oncology
  • Transplantation

Background:

  • Minimizing operative blood loss in liver surgery is essential to prevent postoperative liver failure.
  • Hepatic resection and liver transplantation necessitate effective strategies for managing intraoperative bleeding.

Purpose of the Study:

  • To evaluate and compare the clinical outcomes of Pringle's maneuver versus selective vascular occlusion during elective hepatic resection.
  • To assess the efficacy and safety of modified selective vascular occlusion in living-related liver transplantation.

Main Methods:

  • Elective hepatic resections were performed in 229 patients using Pringle's maneuver (complete, intermittent clamping).
  • 56 patients underwent selective vascular occlusion, including 27 donors for living-related liver transplantation.
  • Clinical outcomes, clamping time, blood loss, and laboratory data (AST levels) were analyzed.

Main Results:

  • Pringle's maneuver group: 64 ± 46 min clamping, 828 ± 665 ml blood loss.
  • Selective vascular occlusion group: 88 ± 44 min clamping, 907 ± 555 ml blood loss.
  • Both methods demonstrated good tolerance, with AST levels normalizing within one week. Morbidity rates were 23% and 27%, with no operative deaths.
  • Modified selective vascular occlusion in transplantation preserved graft viability, with favorable recipient outcomes.

Conclusions:

  • Intermittent total or selective vascular clamping is an indispensable procedure in hepatic resection.
  • Both Pringle's maneuver and selective vascular occlusion are safe and effective, with comparable outcomes.
  • Modified selective vascular occlusion is suitable for preserving graft viability in living-related liver transplantation.

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