Premium
Techniques, hemodynamic monitoring, and indications for vascular clamping during liver resections
Author(s) -
Belghiti Jacques,
Marty Jean,
Farges Olivier
Publication year - 1998
Publication title -
journal of hepato‐biliary‐pancreatic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 0944-1166
DOI - 10.1007/pl00009953
Subject(s) - medicine , vascular occlusion , occlusion , hemodynamics , air embolism , surgery , radiology , embolism , liver disease , cardiology , complication
Prevention of intraoperative blood loss during liver resection is an essential prognostic factor for reducing postoperative morbidity and mortality. Several procedures are currently available to ensure vascular occlusion, ranging from selective clamping of a segmental pedicle to total hepatic vascular occlusion. The type of vascular occlusion should be selected according to the indication and, in particular, according to the site of the tumor, presence of associated underlying liver disease, the patient's cardiovascular status, and the experience of the operator. The surgical strategy should be defined with the anesthesiologist and the type of hemodynamic monitoring selected should allow the best choice for management and prevention of complications such as bleeding and air embolism. Transesophageal echocardiography seems to be a new and promising method in this setting.