Intrahepatic dissection in ablative liver surgery can be accomplished easily and safely with a jet of normal saline generated by a standard agricultural electric sprayer. The jet washes away the intrahepatic parenchyma leaving the ducts and vessels undamaged and easily controlled during dissection. The technique, applied in 45 lobectomies in the dog and in 4 liver resections in man, reduced blood loss.
Orthotopic liver transplantations were performed by one team in 18 dogs using a cuff method to anastomose the portal vein, the suprahepatic vena cava and the infrahepatic vena cava without external or internal shunts. Total and warm ischemic times of donor liver averaged 124 and 32 minutes, respectively. The average occlusion time of the portal vein and the infrahepatic vena cava were 9.7 and 13.9 minutes, respectively. During this time, uncontrolled hypotension, petechiae or hemorrhagic enterogastritis did not develop. Sixteen of 18 dogs survived more than five days, and five dogs lived more than three weeks. The cause of death was not related to the cuff method in any instance. This approach proved to be a technically simple and satisfactory procedure.
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