The main indications and techniques for vascular exclusion of the liver

Arquivos de Gastroenterologia

Eleazar Chaib²  William Abrão Saad²  Ikurou Fujimura¹  Willian Abrão Saad Jr.¹  Joaquim Gama-rodrigues¹ 

[1] ,Liver and Portal Hypertension Surgery Unit

关键词: Hepatectomy;    Constriction;    Liver circulation;    Hemostasis;    surgical;    Hepatectomia;    Constrição;    Circulação hepática;    Hemostasia cirúrgica;   

DOI  :  10.1590/S0004-28032003000200013

来源: SciELO

【 摘 要 】

BACKGROUND: The purpose of vascular clamping during the course of liver resection is to reduce bleeding and subsequent complications. AIM: To show both step-by-step surgical techniques for vascular exclusion of the liver and their indications. METHODS: It is described the following techniques: clamping of the hepatic pedicle, ''Pringle'' maneuver; intermittent clamping of the hepatic pedicle; intermittent vascular exclusion of the liver, without vena cava clamping, and hepatic vascular exclusion with vena cava clamping. Also metabolic and homodynamic consequences as well as the technical failure of the application of each of them are discussed. CONCLUSIONS: The choice of technique to use for clamping during hepatectomy depends on the surgeon's judgment. Dogmatic or systematic attitude, is prejudiciable for the patient and liver surgeon must be able to use all kinds of clamping.

【 授权许可】

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