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March 1957

Differential Hypothermia in Experimental Hepatic Surgery: Application of This Technique to a Problem in Clinical Surgery

Author Affiliations

U. S. N. R.; U. S. N. R.; Boston
Naval Medical Research Institute, Bethesda, Md. (Lt. Huggins and Lt. Carter), and General Surgical Services, Massachusetts General Hospital (Dr. McDermott).

AMA Arch Surg. 1957;74(3):327-332. doi:10.1001/archsurg.1957.01280090025005

Introduction  "The whole problem in cases of resection of the liver has turned upon the question of the control of hemorrhage from the wound."1 Oozing from the cut liver surface results in considerable blood loss and obscures the operative field, making identification and control of bleeding from major vessels difficult. Various techniques of mass hemostasis have been developed to cope with this problem; through-and-through mattress sutures, with or without compression plates,1,2 cautery,3 exteriorization and gradual removal of peripheral hepatic lesions.4 Although success has been reported with these methods, they have the following disadvantages: (1) deliberate resection with definitive hemostasis and control of biliary leakage is not permitted; (2) devitalized tissue is left within the abdomen, and (3) the techniques are suitable only for small peripheral lesions.Preliminary isolation and ligation of vessels supplying and draining the right or left lobe before hepatic lobectomy has been described

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