ObjectiveTo summarize the experiences of precise liver resection for giant complex hepatic neoplasm. MethodsFifty-two cases of giant complex hepatic neoplasms were resected using precise liver resection techniques from April 2008 to August 2009. Hepatic functional reserve and liver imaging were evaluated before operation. Appropriate surgical approach, halfhepatic blood flow occlusion, new technique of liver resection, and intraoperative ultrasonography were applied during operation. ResultsThe mean operative time, halfhepatic blood occlusion time, blood loss, recovery of alanine aminotransferase, and total bilirubin were 350 min (210－440 min), 43 min (8－57 min), 370 ml (250－1 150 ml), 10 d (7－14 d), and 4.5 d (3－10 d), respectively. Only 6 patients had mild bile leakage. No liver failure and other major complications emerged, and no death happened. ConclusionPrecise liver resection is a safe and effective approach for giant complex hepatic neoplasm.
【Abstract】 ObjectiveTo review the advances in techniques of hepatic blood occlusion in hepatectomy. Methods The related literatures were reviewed and analysed. ResultsThere were many techniques of hepatic blood occlusion. The most frequently used and studied techniques were hemihepatic vascular occlusion and intermittent hepatic inflow occlusion. Hepatic vascular exclusion was employed when hepatic veins and/or vena cava would be damaged. Total vascular exclusion and other techniques were rarely used. Conclusion To reduce blood loss in hepatectomy and make patient safe, based on the situation of the patient, the technique should be ingeniously selected.