Application of selective hemihepatic vascular exclusion in hepatectomy of hepatocellular carcinoma
AIM: To investigate the effect of selective hemihepatic vascular exclusion in hepatectomy of hepatocellular carcinoma. METHODS: Ninety-two patients underwent hepetectomy with 3 different hepatic vascular exclusion : 45 patients received hepatectomy with Pringle maneuver (group A ), 30 patients received hepatectomy with hemihepatic vascular exclusion (group B) and 17 patients received hepatectomy with selective hemihepatic vascular exclusion ( group C). Relative surgical parameters, the changes of postoperative liver function, recovery of intestine function and postoperative complications were evaluated and compared. RESULTS: There was no operative mortality. No significant difference was found in intraoperative blood loss, occlusion time, recovery of intestine function, abdominal infections after operation, bile leakage, alimentary tract hemorrhage and refractory ascites among the three groups. The operative time in group B was longer than that in group A and group C ( P < 0.05 ), but no statistically significant difference was seen between group A and group C. The damage of postoperative liver function in group A was worse than that in group B and group C ( P < 0.05 ) but no statistically significant difference was observed between group B and group C. CONCLUSION: Hepatectomy of selective hemihepatic vascular exclusion is better than hepatectomy with Pringle maneuver or hepatectomy with hemihepatic vascular exclusion. Hepatectomy of selective hemihepatic vascular exclusion is an easy and practical method for hepatectomy.