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Published on: March 10, 2023
Liver resection with selective hepatic vascular exclusion: a cohort study
Si-Yuan Fu1, Eric C H Lai, Ai-Jun Li
1The Third Department of Hepatic Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China.
Annals of Surgery
|March 21, 2009
Summary
Selective hepatic vascular exclusion (SHVE) is a safe and effective method for liver resection. This technique is suitable for liver tumors near, but not invading, the inferior vena cava, with excellent hemodynamic tolerance and low morbidity.
Area of Science:
- Hepatobiliary surgery
- Surgical oncology
- Vascular surgery
Background:
- Major and complex liver resections require meticulous surgical techniques.
- Controlling hepatic blood flow is crucial for minimizing blood loss and improving outcomes.
- Selective hepatic vascular exclusion (SHVE) offers a method for temporary interruption of hepatic blood flow.
Purpose of the Study:
- To evaluate the safety and efficacy of SHVE in patients undergoing liver resection.
- To assess the applicability of SHVE for liver tumors adjacent to the inferior vena cava.
Main Methods:
- A prospective study of 246 consecutive patients undergoing liver resection with SHVE.
- Data collected included patient demographics, surgical details, pathology, and postoperative outcomes.
- Different types of SHVE (total, right partial, left partial) were employed based on tumor location.
Main Results:
- SHVE demonstrated excellent hemodynamic tolerance with minimal changes in vascular resistance.
- No perioperative deaths occurred, and the overall morbidity rate was 24.8%.
- The mean hospital stay was 9.6 days, indicating efficient patient recovery.
Conclusions:
- SHVE is a safe and effective surgical strategy for liver resection.
- The technique is well-tolerated hemodynamically and applicable to liver tumors near the inferior vena cava, provided there is no invasion.
- SHVE contributes to favorable postoperative outcomes with low morbidity and mortality.
