Randomized clinical trial comparing infrahepatic inferior vena cava clamping with low central venous pressure in complex liver resections involving the Pringle manoeuvre

Zhu, Peng; Lau, W. Y.; Chen, Y.‐F.; Zhang, B.‐X.; Huang, Zhiyuan; Zhang, Z.‐W.; Zhang, W.; Dou, Lei; Chen, X.‐P.

doi:10.1002/bjs.8714

Cited by 56 publications

(65 citation statements)

References 26 publications

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“…Bias is likely to have been introduced by variation in surgical skill and perioperative care. However, our results were strengthened by a recent large RCT of 192 patients conducted by Zhu et al 15 These scholars indicated that portal triad clamping combined with infrahepatic IVC clamping is more efficacious in controlling bleeding during complex hepatectomies than portal triad clamping with low CVP.…”

Section: Discussioncontrasting

confidence: 65%

Infrahepatic inferior vena cava clamping in hepatectomy for tumors involving hepatocaval confluence

Yang

Sui

Kan

et al. 2013

Asian Journal of Surgery

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Section: Discussioncontrasting

confidence: 65%

Infrahepatic inferior vena cava clamping in hepatectomy for tumors involving hepatocaval confluence

Yang

Sui

Kan

et al. 2013

Asian Journal of Surgery

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“…Eight randomized controlled trials (RCTs) met the inclusion criteria with 339 patients with a significantly lower CVP and 342 control patients. Patient demographics and indications for a hepatic resection are displayed in Table . Bias assessment scores for included trials are presented in Table .…”

Section: Resultsmentioning

confidence: 99%

Central venous pressure and liver resection: a systematic review and meta analysis

Hughes

Ventham

Harrison

et al. 2015

HPB

115

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“…In cases of massive backflow from the hepatic veins, the most frequently used procedures were the control of selective hepatic veins (43%) and IVC clamping (40%). Recently, 2 prospective randomized controlled studies proved the efficacy of IVC clamping for reducing blood loss [35,36]. Total vascular exclusion, in which the infra- and suprahepatic IVCs are clamped, has been reported to be an effective procedure to achieve a bloodless liver resection [20,21].…”

Section: Discussionmentioning

confidence: 99%

A Worldwide Survey of the Current Daily Practice in Liver Surgery

et al. 2013

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Background: Liver resection remains the mainstay of curative treatment for liver malignancies. A variety of preoperative assessments and surgical techniques have improved the short- and long-term outcomes of liver resection in patients with liver tumors. Recently, laparoscopic hepatectomies have been increasingly performed. The aim of the present study is to survey the current practice of liver surgery in high-volume centers in the world. Methods: A questionnaire on the preoperative assessment for liver surgery, open hepatectomy, and laparoscopic hepatectomy was sent to 94 liver centers in the world. Results: Forty-two centers (45%) responded to this survey (29 Asian, 9 European, and 4 North American centers). All but one of the centers evaluated the future liver remnant (FLR) volume, and 95% of them performed preoperative portal vein embolization to increase the FLR volume. In half of the centers, the required FLR volume was over 30% in patients with normal liver and 50% in patients with cirrhotic liver. To reduce the intraoperative blood loss, half of the centers routinely used Pringle’s maneuver, and 85% restricted the intraoperative fluid infusion to reduce the central venous pressure. More than 10 laparoscopic hepatectomies were performed per year in 62% of the centers, and more than 30 were performed in 26%, respectively. Laparoscopic major hepatectomies were performed in 24%. Two-thirds answered that the laparoscopic approach would be feasible in donor hepatectomy. Conclusion: The evaluation of FLR volume in patients with normal or cirrhotic liver and the usage of preoperative portal vein embolization have become essential practice in more than 90% of the centers. Reduced blood loss has been achieved using Pringle’s maneuver, restriction of fluid infusion, and a variety of surgical devises. The laparoscopic approach is increasingly extended to major hepatectomy or donor hepatectomy.

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Randomized clinical trial comparing infrahepatic inferior vena cava clamping with low central venous pressure in complex liver resections involving the Pringle manoeuvre

Abstract: NCT01355887 (http://www.clinicaltrials.gov).

Cited by 56 publications

References 26 publications

Infrahepatic inferior vena cava clamping in hepatectomy for tumors involving hepatocaval confluence

Infrahepatic inferior vena cava clamping in hepatectomy for tumors involving hepatocaval confluence

Central venous pressure and liver resection: a systematic review and meta analysis

A Worldwide Survey of the Current Daily Practice in Liver Surgery

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