Premium
Reducing blood loss in liver surgery
Author(s) -
FAN SHEUNG TAT
Publication year - 2004
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/j.1440-1746.2004.03715.x
Subject(s) - medicine , hepatectomy , surgery , blood loss , liver transplantation , inferior vena cava , hepatocellular carcinoma , vein , transplantation , resection
Reducing blood loss during liver surgery is the major objective and duty of the surgeon because massive blood loss affects both short‐term and long‐term survival of patients having partial hepatectomy or liver transplantation. Bleeding occurs from the liver transection surface, inferior vena cava, hepatic vein, and sometimes iatrogenic rupture of hepatocellular carcinoma. The anterior approach right hepatectomy has been advocated to reduce bleeding resulting from mobilization of the right lobe of liver. Intermittent inflow occlusion has been shown to be beneficial in reducing bleeding during liver transection, but the accumulated ischemic time should not exceed 120 min. The ultrasonic dissector is the best instrument in reducing blood loss during liver transection. Hemostatic material application to the transection surface is usually not required after careful transection of liver with the ultrasonic dissector.