Selective hepatic vascular exclusion for the hepatic resection of HCC.

BACKGROUND/AIMS: Selective hepatic vascular exclusion (SHVE) is an effective technique for the control of bleeding in major hepatic resections. Outcomes of the procedures of the SHVE group were compared with the non-SHVE group.

METHODOLOGY: A retrospective study was carried out of 312 hepatic resections performed over a period of 10 years. The cases in this study were limited to Child's classification A, because of the rate of Child A in the SHVE group (n=82) was significantly higher than that within the non-SHVE group (n=158) (93% vs. 71%; p < 0.001). Preoperative factors, like age, gender, tumor size, intraoperative blood loss, operation time, and the postoperative course of the two groups were compared for both groups.

RESULTS: The SHVE group showed significantly less blood loss, necessary blood transfusion, and a significant rate of severe postoperative complications. The rate of segmentectomy and subsegmentectomy in the SHVE group was higher than in the non-SHVE group, and the rate of partial hepatectomy and lobectomy in the non-SHVE group was higher than that in the SHVE group. Although the more difficult operations were performed in the SHVE group than in the non-SHVE group, there was no significant difference in the postoperative hospital stays in both groups.

CONCLUSIONS: The SHVE technique is effective for bleeding control in major liver resections.