Protection of the liver during partial hepatectomy

作     者：Sheung Tat Fan 

作者机构：Centre for the Study of Liver Disease and Department of Surgery The University of Hong Kong Pokfnlam Hong Kong China 

出 版 物：《Hepatobiliary & Pancreatic Diseases International》 (国际肝胆胰疾病杂志（英文版）)

年 卷 期：2004年第3卷第4期

页      面：490-494页

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：anterior approach middle hepatic vein ultrasonic dissector 

摘      要：BACKGROUND: Liver failure is the most common cause of mortality for patients undergoing partial hepatectomy. Given adequate liver function and remnant liver volume and absence of co-morbid illness, the cause of liver failure is frequently related to technical errors, which induces mas- sive bleeding and ischemic damage to the liver remnant. DATA RESOURCES: From author s practice at Queen Mary Hospital, the University of Hong Kong. RESULTS: To avoid technical errors leading to liver ische- mia and failure, adequate exposure, control of bleeding during liver transection, and planning of transection plane are important. Ultrasonic dissector is the best instrument in liver transection. Its careful use can reduce blood loss and help recognize the hepatic vein, the exposure of which serves as an important landmark for a correct transection plane. Even without Pringle maneuver, minimum bleeding during transection could be achieved. CONCLUSION: Protection of the liver remnant is impor- tant to patient survival after partial hepatectomy. It is achieved by meticulous surgical techniques that reduce bleeding to a minimum.