in situ liver hypothermia followed by prolonged inflow occlusion for hepatectomy in patients with chronic liver disease

in situ liver hypothermia followed by prolonged inflow occlusion for hepatectomy in patients with chronic liver disease

Aim : To assess to preventive effect of simple in situ cooling on ischemic injury in human livers with chronic liver disease. Methods : 30 Patients with chronic liver disease(20 cirrhosis, 6 chronic hepatitis and 4 fatty liver) underwent liver resection following in situ cooling with continuous and prolonged inflow occlusion(In situ cooling), compared with 22 of those who underwent liver resection without cooling(Warm ischemia). In situ hypothermia was induced by introducing cold Ringer(s lactate solution through the portal vein, under conditions of portal triad occlusion. Results : The mean occlusion time was 51.5(7.1±SD) minutes for the in situ cooling group and 54,8±8.3 for the warm ischemia group. After in situ cooling hypoxia-induced liver injury was substantially ameliorated as shown by liver function tests and operative complications. Conclusion : Hepatectomy with prolonged inflow occlusion is justified in patients with chronic liver disease when combined with simple in situ cooling.

Aim : To assess to preventive effect of simple in situ cooling on ischemic injury in human livers with chronic liver disease. Methods : 30 Patients with chronic liver disease(20 cirrhosis, 6 chronic hepatitis and 4 fatty liver) underwent liver resection following in situ cooling with continuous and prolonged inflow occlusion(In situ cooling), compared with 22 of those who underwent liver resection without cooling(Warm ischemia). In situ hypothermia was induced by introducing cold Ringer(s lactate solution through the portal vein, under conditions of portal triad occlusion. Results : The mean occlusion time was 51.5(7.1±SD) minutes for the in situ cooling group and 54,8±8.3 for the warm ischemia group. After in situ cooling hypoxia-induced liver injury was substantially ameliorated as shown by liver function tests and operative complications. Conclusion : Hepatectomy with prolonged inflow occlusion is justified in patients with chronic liver disease when combined with simple in situ cooling.