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Sept 25, 1967

One Hour Hepatic Ischemia Without Serious Damage

JAMA. 1967;201(13):1051. doi:10.1001/jama.1967.03130130077024

To the Editor:—  Since an aggressive surgical approach to resection of major portions of the liver for massive trauma or tumor is currently being suggested1 and liver transplant is being evaluated, the length of time that hepatic ischemia can be effected without permanent damage has increasing significance. Our case is reported because it offers one observation on this point.

Report of a Case:—  A 33-year-old woman with previously demonstrated cholelithiasis was found to have acute cholecystitis, a normal-sized common duct, and a normal liver. As the cystic artery was being dissected, there was sudden severe arterial hemorrhage. Immediate control with finger compression through the foramen of Winslow was accomplished. At 10:09 AM a vascular clamp was placed across the portal triad, with complete control of bleeding. The common hepatic artery was identified and individually clamped in approximately one-half hour, at which time the clamp was removed from the porta