Year 2008 Vol. 16 No 4

PRACTICAL CASES

YURLEVICH D.I., KIRKOVSKY L.V., KOROTKOV S.V., FEDORUK A.M., SHULEYKO A.CH., BOLONKIN L.S., DZYADZKO A.M., SLOBODIN YU. V., SCHERBA A.E., RUMMO O.O.

APPLICATION OF THE SELECTIVE VASCULAR ISOLATION IN THE LIVER SURGERY

One of the priority problems in the liver surgery is decrease of hemorrhage amount. Occlusion use of only the hepatoduodenal ligament at the liver tumors resections localized in the hepatocaval onfluence region or infiltrating vena cava inferior is connected with high risk of massive loss of blood and air embolism. Technique of the liver vascular isolation provides a possibility of safe and aggressive approach to the majority of the focal liver formations. Total vascular liver isolation provides fast and reliable control over hemorrhage, but it is accompanied by the marked hemodynamic disturbances. A clinical case of hemangioma resection, occupying 78 liver segments with the right liver vein inflow from the 6th segment saving in terms of selective vascular resection, is described in the article. The selective vascular resection is shown to be an effective and safe method in case of the right liver lobe tumor resection in the hepatocaval onfluence region. It is more complicated technically due to necessity of the liver veins detection, but it doesnt result in the marked hemadynamic disturbances and the patients bear it better.

Keywords: liver resection, vascular liver isolation.
p. 126 130 of the original issue
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