Sie befinden Sich nicht im Netzwerk der Universität Paderborn. Der Zugriff auf elektronische Ressourcen ist gegebenenfalls nur via VPN oder Shibboleth (DFN-AAI) möglich. mehr Informationen...
Hepatic resection with vascular isolation and routine supraceliac aortic clamping
Ist Teil von
The American journal of surgery, 1996-03, Vol.171 (3), p.351-355
Ort / Verlag
New York, NY: Elsevier Inc
Erscheinungsjahr
1996
Link zum Volltext
Quelle
Elsevier Journal Backfiles on ScienceDirect (DFG Nationallizenzen)
Beschreibungen/Notizen
Hepatic resection with total vascular isolation has been reported to reduce hemorrhage. Addition of supraceliac aortic clamping putatively avoids hemodynamic instability, bdbut may increase morbidity.
This technique was used in 99 major liver resections utilizing scalpel division and suture hemostasis.
Livers were normal in 86 patients,
cirrhotic with no portal hypertension in 5,
and cirrhotic with portal hypertension in 8. There was 1 death in 91 patients with no portal hypertension compared with 5 in 8 patients with portal hypertension due to hepatic failure or bleeding esophageal varices. There were 59 hemihepatectomies and 40 segmentectomies. Median operating time was 145 and 110 minutes,
respectively,
and mean transfused blood was 4 and 0 units, respectively, with minimal morbidity.
Use of total hepatic vascular isolation with routine supraceliac aortic clamping is a safe and expedient method of hepatic resection that limits blood loss and maintains hemodynamic stability, but does not increase morbidity. However, the presence of portal hypertension precludes safe resection.