Does clamping during liver surgery predispose to thrombosis of the hepatic veins? Analysis of 210 cases

作     者：Nikolaos Arkadopoulos Vaia Stafyla Athanasios Marinis Vassilios Koutoulidis Kassiani Theodoraki Theodosios Theodosopoulos Ioannis Vassiliou Nikolaos Dafnios Georgios Fragulidis Vassilios Smyrniotis 

作者机构：Second Department of SurgerySchool of MedicineUniversity of AthensAretaieion University Hospital76 Vassilisis Sofia's Ave11528 AthensGreece First Department of RadiologySchool of MedicineUniversity of Athens Aretaieion University Hospital76 Vassilisis Sofi a's Ave11528 AthensGreece First Department of AnesthesiologySchool of MedicineUniversity of AthensAretaieion University Hospital76 Vassilisis Sofi a's Ave11528 AthensGreece 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2009年第15卷第3期

页      面：339-343页

核心收录：

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

主　　题：CT-angiography Doppler ultrasound Liver resection Pringle maneuver Radiofrequency Selective hepatic vascular exclusion 

摘      要：AIM:To test whether clamping during liver surgery predisposes to hepatic vein ***:We performed a retrospective analysis of 210 patients who underwent liver resection with simultaneous inflow and outflow ***,flow in the hepatic veins was assessed by Doppler ultrasonography during the reperfusion ***,patency of the hepatic veins was assessed by contrast-enhanced CT angiography,when necessary after 3-6 mo follow ***:Twelve patients(5.7%) developed intraoperative liver remnant ***,intraoperative ultrasonography did not reveal evidence of hepatic vein *** three of these patients a kinking of the common trunk of the middle and left hepatic veins hindering outflow was recognized and was managed successfully bysuturing the liver remnant to the *** three patients(10.9%) who developed signs of mild outflow obstruction postoperatively,had no evidence of thrombi in the hepatic veins or flow disturbances on ultrasonography and contrast-enhanced CT angiography,while *** term assessment of the patency of the hepatic veins over a 3-6 mo follow-up period did not reveal thrombi formation or clinical manifestations of out flow ***:Extrahepatic dissection and clamping of the hepatic veins does not predispose to clinically important thrombosis.