Chaib Eleazar, Saad William Abrão, Fujimura Ikurou, Saad Willian Abrão, Gama-Rodrigues Joaquim
Liver and Portal Hypertension Surgery Unit, University of São Paulo School of Medicine, São Paulo, SP, Brazil.
Arq Gastroenterol. 2003 Apr-Jun;40(2):131-6. doi: 10.1590/s0004-28032003000200013. Epub 2004 Jan 16.
The purpose of vascular clamping during the course of liver resection is to reduce bleeding and subsequent complications.
To show both step-by-step surgical techniques for vascular exclusion of the liver and their indications.
It is described the following techniques: clamping of the hepatic pedicle, "Pringle" maneuver; intermittent clamping of the hepatic pedicle; intermittent vascular exclusion of the liver, without vena cava clamping, and hepatic vascular exclusion with vena cava clamping. Also metabolic and homodynamic consequences as well as the technical failure of the application of each of them are discussed.
The choice of technique to use for clamping during hepatectomy depends on the surgeon's judgment. Dogmatic or systematic attitude, is prejudiciable for the patient and liver surgeon must be able to use all kinds of clamping.
肝切除术中进行血管钳夹的目的是减少出血及后续并发症。
展示肝脏血管阻断的分步手术技术及其适应证。
描述了以下技术：肝蒂钳夹（“Pringle”手法）；肝蒂间歇性钳夹；不夹闭腔静脉的肝脏间歇性血管阻断以及夹闭腔静脉的肝脏血管阻断。还讨论了每种技术的代谢和血流动力学后果以及应用中的技术失败情况。
肝切除术中钳夹技术的选择取决于外科医生的判断。教条或系统化的态度对患者是有害的，肝脏外科医生必须能够使用各种钳夹技术。
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