Open AccessMajor Hepatic Resection Using Vascular Isolation and Hypothermic Perfusion
Author(s) -
Joseph G. Fortner,
Man H. Shiu,
David W. Kinne,
D. K. Kim,
El B. Castro,
Robin C. Watson,
William S. Howland,
Edward Beattie
Publication year - 1974
Publication title -
annals of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.153
H-Index - 309
eISSN - 1528-1140
pISSN - 0003-4932
DOI - 10.1097/00000658-197410000-00030
Subject(s) - medicine , perfusion , isolation (microbiology) , cardiology , bioinformatics , biology
The technique and results of 29 major hepatic resections using the method of complete vascular isolation and hypothermic perfusion of the liver are reported. The method enables the surgeon to perform otherwise difficult or impossible resections through chilled bloodless hepatic parenchyma. Major intrahepatic vascular structures can thus be recognized and controlled readily under clear vision. Direct neoplastic involvement of, or tumor thrombi in the portal vein, hepatic vein or vena cava, can be successfully dealt with by appropriate surgical measures. The operative mortality was 10.3% for this series which included many tumors previously deemed unresectable. The technical detail and intraoperative physiologic monitoring crucial to success in the use of the method are described. It is hoped that with the widened scope of resectability afforded by this technique, and the use of adjuvant chemotherapy, the currently experienced low cure rates for hepatic cancer can be improved.