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June 1994

In Situ and Surface Liver Cooling With Prolonged Inflow Occlusion During Hepatectomy in Patients With Chronic Liver Disease

Author Affiliations

From the Department of Surgery I, Oita Medical University, Oita, Japan.

Arch Surg. 1994;129(6):620-624. doi:10.1001/archsurg.1994.01420300062009

Objective:  We examined in situ and surface liver hypothermia with continuous and prolonged inflow occlusion during hepatic resection (segmentectomy or subsegmentectomy).

Participants:  Eight patients with cirrhosis and three with chronic hepatitis.

Method:  In situ chilling was achieved by introducing cold Ringer's lactate solutoin through the portal vein, under conditions of portal triad occlusion.

Results:  The liver tissue temperature fell to a mean of 28.4°C 5 minutes later. The time of ischemia ranged from 32 to 52 minutes (mean±SD, 47.8±5.6 minutes). The mean blood loss was significantly lower than in our conventional hepatectomy series (680 vs 1520 mL, P<.02).

Main Outcome:  There were no serious complications, and hypoxia-induced liver injury was ameliorated, as shown by liver function tests.

Conclusion:  Hepatectomy with prolonged inflow occlusion is justified in low-risk patients with chronic liver disease if it is combined with liver hypothermia, such as simple in situ and surface cooling.(Arch Surg. 1994;129:620-624)