Dramatic improvements in morbidity and mortality rates following liver rese
ctions have been reported in the past decade. Consequently, the indications
for hepatectomy are becoming more liberal. Many techniques of liver resect
ion with or without vascular clamping have been reported with excellent cli
nical results. Total vascular exclusion (TVE) of the liver during parenchym
al transection has been advocated susceptible to increase the resectability
of tumors that might not be safely approached by other techniques. Cirrhot
ic livers are probably more vulnerable to ischemic injury related to TVE th
an normal livers. The indications and technical and metabolic aspects of th
e technique are reviewed. (C) 1999 Wiley-Liss, Inc.