Continuous occlusion of hepatic artery proper for prevention of blood loss in partial hepatectomy for ruptured hepatocellular carcinoma: a case-matched comparative study.

Abstract:

BACKGROUND:To investigate the efficacy and safety of adding continuous occlusion of hepatic artery proper to intermittent Pringle maneuver in partial hepatectomy for ruptured hepatocellular carcinoma. MATERIALS AND METHODS:This is a retrospective study on data that were prospectively collected and entered into a computer database. A total of 36 patients who underwent partial hepatectomy for ruptured HCC by adding continuous occlusion of hepatic artery proper to intermittent Pringle maneuver at a tertiary care university hospital were compared with a historical case-matched control group of 36 patients who received intermittent Pringle maneuver only. RESULTS:The patient characteristics were comparable for the 2 groups of patients. The mean hepatic artery occlusion time was 58 min (range 36-98 min). Intraoperative blood loss and blood transfusion rate in the study group were significantly lower than the control group (P < .001 and P = .004, respectively). There were no significant differences in the postoperative serum aspartate transaminase and total bilirubin levels (P = .087, P = .135, respectively), and in the postoperative hospital stay and surgical complications according to Clavien's classification between the two groups (P = 0.213, P = 1.000, respectively). The disease-free survival rates in the study group was significantly better than the control group (P = .023). Overall, HCC patients with rupture had poor prognosis. CONCLUSIONS:The addition of continuous occlusion of hepatic artery proper to intermittent Pringle maneuver significantly reduced intraoperative blood loss for partial hepatectomy in patients with ruptured HCC when compared with intermittent Pringle maneuver alone. The procedure was found to be safe even for patients with liver cirrhosis.

journal_name

Ann Surg Oncol

authors

Xia F,Lau WY,Qian C,Ma K,Li X,Bie P

doi

10.1245/s10434-010-1484-3

subject

Has Abstract

pub_date

2011-06-01 00:00:00

pages

1638-43

issue

6

eissn

1068-9265

issn

1534-4681

journal_volume

18

pub_type

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