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In Situ and Surface Liver Cooling With Prolonged Inflow Occlusion During Hepatectomy in Patients With Chronic Liver Disease

Yang Il Kim, MD; Michio Kobayashi, MD; Kimihiro Nakashima, MD; Masanori Aramaki, MD; Takanori Yoshida, MD; Yoshinobu Mitarai, MD
Arch Surg. 1994;129(6):620-624. doi:10.1001/archsurg.1994.01420300062009.
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Objective:  We examined in situ and surface liver hypothermia with continuous and prolonged inflow occlusion during hepatic resection (segmentectomy or subsegmentectomy).

Participants:  Eight patients with cirrhosis and three with chronic hepatitis.

Method:  In situ chilling was achieved by introducing cold Ringer's lactate solutoin through the portal vein, under conditions of portal triad occlusion.

Results:  The liver tissue temperature fell to a mean of 28.4°C 5 minutes later. The time of ischemia ranged from 32 to 52 minutes (mean±SD, 47.8±5.6 minutes). The mean blood loss was significantly lower than in our conventional hepatectomy series (680 vs 1520 mL, P<.02).

Main Outcome:  There were no serious complications, and hypoxia-induced liver injury was ameliorated, as shown by liver function tests.

Conclusion:  Hepatectomy with prolonged inflow occlusion is justified in low-risk patients with chronic liver disease if it is combined with liver hypothermia, such as simple in situ and surface cooling.(Arch Surg. 1994;129:620-624)


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