Although successful subtotal hepatic resections for neoplastic and traumatic lesions have been carried out, the scope of this procedure is limited by the extreme vascularity and friability of hepatic tissue.1-4 In the past, control of hemorrhage from the liver has been effected by short periods of occlusion of the hepatic afferent blood supply at normal body temperature. More recently, the use of moderate hypothermia has considerably extended the safe period of inflow occlusion, although sustained periods of ischemia still introduce the risk of liver necrosis.
Previous investigators have determined the tolerance of normothermic and hypothermic dogs to total hepatic afferent occlusion under normobaric conditions.5,6 At normal body temperature (37 C), ischemic periods of 20 minutes are well tolerated while longer intervals of interruption of hepatic blood flow are associated with a mortality rate which approaches 100% at 60 minutes. Surface cooling to a mean body temperature of 25-31
TANK ES, FRITTELLI G, VAWTER GF, BERNHARD WF. Hepatic Afferent Vascular OcclusionTolerance in Normothermic and Hypothermic Animals at 1.0 and 3.4 Atmospheres Absolute. Arch Surg. 1964;89(2):340-343. doi:10.1001/archsurg.1964.01320020104016