Intermittent portal triad clamping in resection of liver tumors involving the hepatocaval confluence

作     者：Wang Y. Chen H. Sun Y.-F. Wei G.-T. Wu M.-C. 

作者机构：Second Department of Hepatic Surgery Eastern Hepatobiliary Hospital Second Military Medical University Shanghai 200438 China 

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

年 卷 期：2002年第1卷第2期

页      面：276-280页

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：hepatectomy hepatocval confluence portal triad clamping hepatic vascular exclusion liver neoplasmas 

摘      要：Objective: To review our experience in and the re-sults of resecting liver tumors involving the hepatoca-val confluence under intermittent portal triad clam-ping (PTC).Methods: Sixty-eight consecutive patients with livertumors involving the hepatocaval confluence under-went hepatectomies with liver parenchymal transec-tions under intermittent ***: All the tumors were successfully resected un-der PTC, except for one in which the infrahepatic in-ferior vena cava was concomitantly occluded in addi-tion to PTC. There was neither operative death noruncontrollable massive bleeding or air embolism oc-curred in our patients. The bleedings from the mainand short hepatic veins and right adrenal veins wereproperly managed during the operation, with a meanintraoperative blood loss of 1400 ml. Of the 68tumors resected, 65 were hepatocellular carcinomas(HCC). Their 1-, 2-, 3- and 4-year suvival rateswere 64.11%, 52. 82%, 44.90% and 36.98%, re-spectively, and the patients with HCC with capsulessurvived significantly longer than those with HCCwithout ***: The liver tumors involving the hepato-caval confluence could be safely resected simply un-der PTC, without routine use of total hepatic vascu-lar exclusion. As for HCCs in this area, the tumorwith capsule is a better indicator for surgical resec-tion than that without capsule.