TAILIEUCHUNG - Methods of hepatic vascular control for liver resection

Controlling and reduction of the bleeding are one of the key factors in liver resection, to ensure a safe resection, and to reduce post-operative complication, especially post-operative liver failure. Hepatic vascular clamping helps to reduce intra-operative bleeding. | Hue Central Hospital METHODS OF HEPATIC VASCULAR CONTROL FOR LIVER RESECTION Ninh Viet Khai Chu Minh Phuc ABSTRACT Controlling and reduction of the bleeding are one of the key factors in liver resection to ensure a safe resection and to reduce post-operative complication especially post-operative liver failure. Hepatic vascular clamping helps to reduce intra-operative bleeding. Each method of controlling hepatic vascular needs to be applied accordingly to each injury liver parenchymal condition. Understanding of hepatic vascular control techniques in liver resection is very useful for surgeons when conducting hepatectomy I. INTRODUCTION Controlling and reduction of the bleeding are one of the key factors in liver resection to ensure a safe resection and to reduce post-operative complication especially post-operative liver failure. Hepatic vascular clamping helps to reduce intra-operative bleeding. The main disadvantage of this is parenchymal damage due to ischemia and reperfusion after clamping. Especially prolonged vascular clamping in those with pre-existing disease such as cirrhosis hepatosteatosis. can cause post-operative liver failure which is a major cause of post-operative mortality. Vascular control can be done for the inflow or both the inflow and outflow. With the advance in liver anatomy knowledge and in anesthesiology and especially with the introduction of modern devices to resect liver parenchyma bipolar electrocautery CUSA and ultrasonic scalpel. liver resection especially major hepatectomy can be done without vascular control. Each method of controlling hepatic vascular needs to be applied accordingly to each injury liver parenchymal condition and cardiovascular Duc Hospital Corresponding author Ninh Viet Khai Email drninhvietkhai@ Received 10 5 2019 Revised 17 5 2019 Accepted 14 6 2019 disease of patient concerned with the benefits of controlling blood loss with the risk of parenchymal damage due to anemia when the vascular control