Application of infrahepatic inferior vena cava clamping combined with Pringle maneuver in complex hepatectomy        SUI Cheng-jun, SHEN Wei-feng, LU Jiong-jiong, et al. Department of Special Medical Care Ⅰ and Liver Transplantation, Eastern Hepatobiliary Hospital,the Second Military Medical University, Shanghai 200438, China
Corresponding author: YANG Jia-mei, E-mail:jmyang@smmu.edu.cn
Abstract    Objective    To explore the clinical value of infrahepatic inferior vena cava(IVC) clamping combined with Pringle maneuver in complex hepatectomy. Methods    Ninety one cases who underwent hepatectomy between March 2010 and December 2011 were eligible and analyzed retrospectively.IVC clamping combined with Pringle maneuver was applied to 43 cases(group A) and Pringle maneuver alone was applied to 48 cases(group B).Data on patient demographics, surgical procedure and outcome were collected and compared between the two groups. Results    Total intraoperative blood loss (312.79±267.28 mL vs. 471.04±317.80 mL, P=0.01) and blood loss during parenchymal transaction (80.70±79.77 mL vs. 200.21±165.09 mL, P =0.00) were significantly less in group A than in group B.The CVP was 8.47±2.60 cmH2O before IVC clamping and 1.81±2.34 cmH2O after IVC clamping in group A, which decreased by 6.66 cmH2O (P<0.05). And the CVP was significantly lower in group A than in group B during parenchymal transection (1.81±2.34 cmH2O vs. 7.21±2.27 cmH2O, P<0.05). The postoperative liver and renal functions and total morbidity rates were comparable between the two groups. Conclusion    Infrahepatic IVC clamping combined with Pringle maneuver is a safe and effective technique in complex hepatectomy, which may lower the CVP and reduce intraoperative blood loss significantly.