Terblanche J, Krige J E, Bornman P C
Department of Surgery, University of Cape Town, South Africa.
Arch Surg. 1991 Mar;126(3):298-301. doi: 10.1001/archsurg.1991.01410270038006.
Ten consecutive patients scheduled to undergo liver resection were studied prospectively with the use of a standard protocol, which included routine vascular inflow occlusion to reduce blood loss and blood transfusion requirements. Fibrin sealant was sprayed on the raw liver surface, and abdominal drainage was not performed. No deaths occurred, and the postoperative course was remarkably smooth. The normothermic liver ischemic times of 30 to 122 minutes (mean, 73 minutes) were well tolerated. The amount of blood transfused was reduced to a mean of 2 U (range, 0 to 4 U). The occurrence of infected intraabdominal bile collections in two patients with preexisting biliary tract infection suggested that abdominal drainage should be performed in such patients. Vascular inflow occlusion is recommended for all liver resections.
我们前瞻性地研究了连续10例计划接受肝切除术的患者，采用了标准方案，其中包括常规的血管流入阻断以减少失血量和输血需求。将纤维蛋白密封剂喷洒在肝脏创面，未进行腹腔引流。无死亡病例发生，术后过程非常顺利。30至122分钟（平均73分钟）的常温肝脏缺血时间耐受性良好。输血量减少至平均2单位（范围为0至4单位）。两名既往有胆道感染的患者发生了腹腔内感染性胆汁积聚，提示此类患者应进行腹腔引流。建议所有肝切除术均采用血管流入阻断。
