[Possibilities of controlling blood less in liver resection]

The methods are described by which blood loss can be reduced during hepatic surgery. This requires the proper surgical techniques (control method of hepatic lobectomy and occasionally the atypical resection with the use of a clamp- "crush" method). In additions clamping of the liver hilus and resection under hypothermia, the resection of the isolated bloodless organ under hypothermia, the application of an internal caval shunt, intraoperative autotransfusion, and acute preoperative hemodilution should be performed. The internal caval shunt can be successfully used in the case of emergency as well as during excision of large tumors which have involved the liver tissue adjacent to the vena cava. In these cases the method of complete vascular isolation and hypothermic perfusion should be performed additionally. Acute preoperative hemodilution should be widely applied with hepatic surgery; blood clotting is not impaired by this method.