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Titolo:
Liver resections with or without pedicle clamping
Autore:
Nuzzo, G; Giuliante, F; Giovannini, I; Vellone, M; De Cosmo, G; Capelli, G;
Indirizzi:
Catholic Univ Sacred Heart, Sch Med, Dept Surg, Hepatobiliary Surg Unit, I-00168 Rome, Italy Catholic Univ Sacred Heart Rome Italy I-00168 Unit, I-00168 Rome, Italy Catholic Univ Sacred Heart, Sch Med, Dept Anesthesiol, I-00168 Rome, ItalyCatholic Univ Sacred Heart Rome Italy I-00168 esiol, I-00168 Rome, Italy Catholic Univ Sacred Heart, Sch Med, Inst Hyg, I-00168 Rome, Italy Catholic Univ Sacred Heart Rome Italy I-00168 t Hyg, I-00168 Rome, Italy
Titolo Testata:
AMERICAN JOURNAL OF SURGERY
fascicolo: 3, volume: 181, anno: 2001,
pagine: 238 - 246
SICI:
0002-9610(200103)181:3<238:LRWOWP>2.0.ZU;2-#
Fonte:
ISI
Lingua:
ENG
Soggetto:
TOTAL VASCULAR EXCLUSION; PERIOPERATIVE BLOOD-TRANSFUSION; HEPATIC RESECTION; HEPATOCELLULAR-CARCINOMA; PORTAL TRIAD; NORMOTHERMIC ISCHEMIA; INFLOW OCCLUSION; HEPATECTOMY; MANAGEMENT; SURVIVAL;
Keywords:
liver resections; liver ischemia; hepatic pedicle clamping;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
39
Recensione:
Indirizzi per estratti:
Indirizzo: Nuzzo, G Catholic Univ Sacred Heart, Sch Med, Dept Surg, Hepatobiliary Surg Unit, Lgo A Gemelli 8, I-00168 Rome, Italy Catholic Univ Sacred Heart LgoA Gemelli 8 Rome Italy I-00168 ly
Citazione:
G. Nuzzo et al., "Liver resections with or without pedicle clamping", AM J SURG, 181(3), 2001, pp. 238-246

Abstract

Background: Decreasing operative bleeding during liver resection, and thusextent of transfusions, has become a main criterion to evaluate operative results of hepatectomies. Hepatic pedicle clamping (HPC) is widely used forthis purpose. The aim of the study was to evaluate safety, efficacy, technique, and contraindications of HPC during liver resections, comparing results of resections performed with or without HPC. Methods: Data from 245 liver resections were analyzed. In all, 125 resections were performed with HPC group Al, continuous in 100 cases and intermittent in 25 cases. The average duration of ischemia in group A was 39 +/- 20 minutes (range 7 to 107). In 20-cases (16%) ischemia was prolonged for 60 minutes or more. A total of 120 resections were performed without HPC ((group B). Major resections were 53.6% in group A (67 cases) and 38.3% in group B (46 cases). Cirrhosis was present in 36 cases, 19 in group A and 17 in group B. Results: Operative mortality was nil. Postoperative mortality was 2.9%, morbidity 22.4%. Percentage of transfused cases (34.4% versus 60.0%; P < 0.001) and number of blood units per transfused case (2 + 1 versus 4 <plus/minus> 3; P < 0.001) were lower ingroup A versus group B, Similar figures were found by considering only major resections. Postoperative blood chemistriesdid not show important differences between the two groups,: and postoperative alterations were related more to extent and complexity of the operationthan to length of HPC. Conclusions: HPC during liver resection is a safe and:effective technique. This is demonstrated in a context where HPC is used continuously in most cases, intermittently in cases with impaired liver function and for more prolonged ischemia, and avoided in cases with Limited bleeding, jaundice, and simultaneous bowel anastomoses. (C) 2001 Excerpta Medica, Inc. All rights reserved.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 30/09/20 alle ore 03:05:39