Liver resection with total vascular exclusion for malignant tumours

Area of Science:

• Hepatobiliary Surgery
• Surgical Oncology
• Vascular Surgery

Background:

• Liver resections for malignant tumors are complex procedures.
• Total vascular exclusion (TVE) is a technique used to minimize blood loss during liver surgery.
• Its impact on outcomes in patients without cirrhosis requires further investigation.

Purpose of the Study:

• To evaluate the effects of total vascular exclusion (TVE) in liver resections for malignant tumors in patients without cirrhosis.
• To analyze blood loss, transfusion requirements, and postoperative outcomes associated with TVE.

Main Methods:

• Retrospective review of 47 patients without cirrhosis undergoing 56 liver resections using TVE.
• Analysis of intraoperative blood loss, blood transfusion volumes, and postoperative hospital stay.
• Assessment of factors influencing postoperative prothrombin time, aspartate aminotransferase, and bilirubin levels.

Main Results:

• Mean blood loss was 1651 ml and mean intraoperative transfusion was 930 ml.
• 32% of resections required no blood transfusion.
• Postoperative hospital stay averaged 19.7 days, with a 4% hospital mortality rate.
• Postoperative prothrombin time was affected by resection volume and TVE duration, but not transfusion amount.

Conclusions:

• Total vascular exclusion (TVE) is a feasible technique for liver resection in non-cirrhotic patients with malignant tumors.
• Blood loss and transfusion requirements are manageable.
• Postoperative liver function markers are not significantly impacted by transfusion volume, but are influenced by resection extent and TVE duration.