Systematic Use of Total Vascular Exclusion in 14 Elective Hepatic Resections

Abstract

Between March 1992 and May 1995, 14 hepatic resections under total vascular exclusion were performed (10 major resections and 4 minor resections involving central segments). Mean age was 64 years (SD ± 12). During hepatic resection, 4 patients required blood transfusion. The reason was a too low level of haemoglobin (< 10 gr/100 ml) to undergo Hepatic Vascular Exclusion (HVE) (1 patient), an unacceptable decrease in blood pressure following HVE leading to insertion of venovenous bypass (1 patient), or an extensive bleeding following removal of the clamps (2 patients). The 10 remaining patients did not need peroperative blood transfusion. Two patients were transfused after the 6th postoperative day.

Complications usually described during HVE were not encountered except for one pleural effusion needing thoracocentesis.

Key words:

• Hepatectomy
• total vascular exclusion
• hepatic vascular exclusion
• blood transfusion
• clamping