LIVER RESECTIONS PERFORMED UNDER PROLONGED PORTAL TRIAD OCCLUSION IN PATIENTS WITH ACTIVE CHRONIC LIVER-DISEASES

We analyzed the results of hepatic resections performed during the pas t 5 years on 27 patients with active chronic liver diseases. The patie nts included 5 with chronic active hepatitis and 22 with active liver cirrhosis, all of whom had a serum alaninine aminotransferase (ALT) le vel of more than 100 U/I on admission. Fourteen patients underwent hep atectomy by the conventional method (group 1), and 13 were treated by liver resection with portal triad occlusion (PTO) ranging from 32 to 7 5 min (group 2). The mean blood loss was significantly lower in group 2 than in group 1, being 630 versus 1,491 ml (P < 0.05). No serious co mplications developed in any of the group 2 patients, whereas liver fa ilure occurred in three of the group 1 patients, two of whom died. The serum bilirubin levels were stabilized in group 2 from 14 days after surgery, whereas the values in group 1 remained elevated. These result s indicate that prolonged hepatic inflow occlusion can be used during surgery in selected patients with active chronic liver diseases.