Hepatic blood inflow occlusion without hemihepatic artery control in treatment of hepatocellular carcinoma
摘要AIM: To investigate the clinical significance of hepatic blood inflow occlusion without hemihepatic artery control (BIOwHAC) in the treatment of hepatocellular carcinoma(HCC).METHODS: Fifty-nine patients with HCC were divided into 3 groups based on the technique used for achieving hepatic vascular occlusion: group 1, vascular occlusion was achieved by the Pringle maneuver (n=20);group 2, by hemihepatic vascular occlusion (HVO) (n=20); and group 3, by BIOwHAC (n=19). We compared the procedures among the three groups in term of operation time, intraoperative bleeding, postoperative liver function, postoperative complications, and length of hospital stay.RESULTS: There were no statistically significant differences (P>0.05) in age, sex, pathological diagnosis,preoperative Child’s disease grade, hepatic function, and tumor size among the three groups. No intraoperative complications or deaths occurrred, and there were no significant intergroup differences (P>0.05) in intraoperative bleeding, hepatic function change 3 and 7 d after operation, the incidence of complications, and length of hospital stay. BIOwHAC and Pringle maneuver required a significantly shorter operation time than HVO; the difference in the serum alanine aminotransferase or aspartate aminotransferase levels before and 1 d after operation was more significant in the BIOwHAC and HVO groups than in the Pringle maneuver group (P<0.05).CONCLUSION: BIOwHAC is convenient and safe; this technique causes slight hepatic ischemia-reperfusion injury similar to HVO.
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