Vascular exclusion in surgery of the liver: experimental basis, technic, and clinical results

Because liver exeresis and surgery for liver trauma still carry a great mortality by hemorrhage or air embolism due to suprahepatic or vena cava injuries, temporary vascular exclusion of the liver is considered. Based on hemodynamic, biologic, and anatomopathologic experimental and clinical data, a catheter was designed that allows isolation of the retro-and suprahepatic portions of the inferior vena cava and consequently vascular exclusion of the liver for 30 minutes. We report on seven patients in whom this technic was utilized (4 requiring hepatectomy and 3 traumatized), confirming the utility, ease, and efficacy of this method.