HEPATECTOMY INCLUDING MORE THAN HALF OF LIVER VOLUME WITH INTERMITTENT PORTAL TRIAD OCCLUSION

INTRODUCTION: liver resections over 50% of hepatic volume can be achie ved with a low morbi-mortality, although occasionally they are followe d by severe complications. Postoperative evolution and complications a fter this type of hepatic resections with intermittent occlusion of th e portal triad have been studied. PATIENTS AND METHODS: 13 right hepat ectomies, 5 enlarged right hepatectomies and 2 enlarged left hepatecto mies were performed consecutively, with intraoperative ultrasound eval uation and intermittent portal triad occlusion. RESULTS: maximum time of continuous hepatic hilum occlusion was 15 minutes, with a mean isqu emia time of 25 +/- 8.6 minutes; Peak of disturbance of hepatic functi on was at 24 hours and recovered totally at 7th postoperative day. Nin e of the 20 patients (45%) did not need intraoperative transfusion and the average of transfusion was 1.8 +/- 1.9 blood units. Four biliary leaks (20%), with no severe hepatic disfunction were observed during p ostoperative period, and there was no hospital mortality. CONCLUSIONS: intermittent portal triad occlusion during hepatic resections in more than 50% of liver volume is a safe surgical maneuver.