Liver resections performed under prolonged portal triad occlusion in patients with active chronic liver diseases

We analyzed the results of hepatic resections performed during the past 5 years on 27 patients with active chronic liver diseases. The patients included 5 with chronic active hepatitis and 22 with active liver cirrhosis, all of whom had a serum alanine aminotransferase (ALT) level of more than 100 U/l on admission. Fourteen patients underwent hepatectomy by the conventional method (group 1), and 13 were treated by liver resection with portal triad occlusion (PTO) ranging from 32 to 75 min (group 2). The mean blood loss was significantly lower in group 2 than in group 1, being 630 versus 1,491 ml (P < 0.05). No serious complications developed in any of the group 2 patients, whereas liver failure occurred in three of the group 1 patients, two of whom died. The serum bilirubin levels were stabilized in group 2 from 14 days after surgery, whereas the values in group 1 remained elevated. These results indicate that prolonged hepatic inflow occlusion can be used during surgery in selected patients with active chronic liver diseases.