Infrahepatic Inferior Vena Cava Clamping Reduces Blood Loss during Liver Transection for Cholangiocarcinoma.

IF 1.5 Q3 GASTROENTEROLOGY & HEPATOLOGY

International Journal of Hepatology Pub Date : 2021-08-26 eCollection Date: 2021-01-01 DOI:10.1155/2021/1625717

Natwutpong Leeratanakachorn, Vor Luvira, Theerawee Tipwaratorn, Suapa Theeragul, Apiwat Jarearnrat, Attapol Titapun, Tharatip Srisuk, Supot Kamsa-Ard, Ake Pugkhem, Narong Khuntikeo, Chawalit Pairojkul, Vajarabhongsa Bhudhisawasdi

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引用次数: 4

Abstract

Background: Major hepatectomy is the mainstay of the treatment for cholangiocarcinoma. Infrahepatic inferior vena cava (IVC) clamping is an effective maneuver for reducing blood loss during liver transection. The impact of this procedure on major hepatectomy for cholangiocarcinoma is unknown. This study evaluated the effect of infrahepatic IVC clamping on blood loss during liver transection.

Methods: Clinical and pathological data were collected retrospectively for 116 cholangiocarcinoma patients who underwent major hepatectomy between January 2015 and December 2016, to investigate the benefit of infrahepatic IVC clamping. Two of five surgeons adapted the policy performing infrahepatic IVC clamping during liver transection in all cases. Patients, therefore, were divided into those (n = 39; 33.6%) who received infrahepatic IVC clamping during liver transection (C1) and those (n = 77; 66.4%) who did not (C0).

Results: The patients' backgrounds, operative parameters, and extent of hepatectomy did not differ significantly between the 2 groups, except for gender. A significantly lower blood loss (p = 0.028), blood transfusion (p = 0.011), and rate of vascular inflow occlusion requirement (p < 0.001) were observed in the C1 group. The respective blood losses in the C1 group and the C0 group were 498.9 (95% CI: 375.8-622.1) and 685.6 (95% CI: 571-800.2) millilitres.

Conclusions: The current study found infrahepatic IVC clamping during liver transection for cholangiocarcinoma reduces blood loss, blood transfusion, and rate of vascular inflow occlusion requirement.

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肝下腔静脉夹紧可减少胆管癌肝切断术中的出血量。

背景:肝大切除术是胆管癌的主要治疗方法。肝下腔静脉(IVC)夹紧是肝横断术中减少失血的有效方法。该手术对胆管癌大肝切除术的影响尚不清楚。本研究评估肝下IVC夹紧对肝横断术中出血量的影响。方法:回顾性收集2015年1月至2016年12月行肝大切除术的116例胆管癌患者的临床及病理资料，探讨肝下IVC夹持术的疗效。在所有病例中，5名外科医生中有2名采用了肝下腔静脉夹紧术。因此，将患者分为两组(n = 39;33.6%的患者在肝横断(C1)时接受肝下IVC夹持(n = 77;66.4%)未见(C0)。结果:除性别差异外，两组患者背景、手术参数、肝切除程度无显著差异。C1组出血量(p = 0.028)、输血量(p = 0.011)和血管流入阻塞率(p < 0.001)均显著降低。C1组和C0组的出血量分别为498.9 (95% CI: 375.8-622.1)和685.6 (95% CI: 571-800.2)毫升。结论:目前的研究发现，胆管癌肝切断术中肝下IVC夹紧可减少出血量、输血和血管流入阻塞率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Hepatology GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

3.80

自引率

0.00%

发文量

审稿时长

15 weeks

期刊介绍： International Journal of Hepatology is a peer-reviewed, Open Access journal that publishes original research articles, review articles, and clinical studies related to the medical, surgical, pathological, biochemical, and physiological aspects of hepatology, as well as the management of disorders affecting the liver, gallbladder, biliary tree, and pancreas.