2005
DOI: 10.1097/01.sla.0000157168.26021.b8
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Complete Versus Selective Portal Triad Clamping for Minor Liver Resections

Abstract: Both techniques of clamping are equally effective and feasible for patients with normal liver and undergoing minor hepatectomies. However, in cirrhotic patients selective clamping induces less ischemic injury and should be recommended. Finally, even for minor hepatic resections, central venous pressure, HVPG, and intraoperative blood loss are factors related to morbidity and should be considered.

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Cited by 123 publications
(81 citation statements)
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“…A meta-analysis of 4 randomized controlled trials (RCTs) comparing hemi-hepatic (selective) versus total vascular inflow clamping has not revealed any significant advantage, although AST levels on day 1 were lower in the hemi-hepatic clamping group [21]. Selective clamping is, however, preferred for minor hepatectomies and resections on cirrhotic livers as demonstrated by an RCT [22]. It is pertinent to note that selective clamping is associated with the need for extensive hilar dissection, although a technique of avoiding this has been described [23].…”
Section: Discussionmentioning
confidence: 99%
“…A meta-analysis of 4 randomized controlled trials (RCTs) comparing hemi-hepatic (selective) versus total vascular inflow clamping has not revealed any significant advantage, although AST levels on day 1 were lower in the hemi-hepatic clamping group [21]. Selective clamping is, however, preferred for minor hepatectomies and resections on cirrhotic livers as demonstrated by an RCT [22]. It is pertinent to note that selective clamping is associated with the need for extensive hilar dissection, although a technique of avoiding this has been described [23].…”
Section: Discussionmentioning
confidence: 99%
“…However, the results of surgical series depend mostly on hospital volume and surgeon expertise. Few randomized and well‐designed control studies have been reported 8–12 …”
Section: Introductionmentioning
confidence: 99%
“…These techniques of vascular inflow occlusion not only reduce intraoperative blood loss but also minimize postischemic reperfusion injury [18][19][20]. This negative result may have several explanations.…”
Section: Discussionmentioning
confidence: 99%