Total vascular exclusion for liver resections: Pros and cons

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.