Huguet C, Gavelli A, Bona S
Department of Surgery, Princess Grace Hospital, Principality of Monaco.
J Am Coll Surg. 1994 May;178(5):454-8.
Twenty-six hepatic resections were performed using vascular clamping lasting more than one hour. The average duration of continuous normothermic ischemia was 67.0 +/- 7.5 minutes (plus or minus standard error of the mean) (range of 60 to 85 minutes). Vascular occlusion consisted of simple portal triad clamping in 14 patients and of hepatic vascular exclusion in 12. Extensive hepatectomy was performed upon more than 80 percent of the patients. One postoperative death was recorded. Extensive complications occurred in eight patients, including one case of hepatic failure. Postoperative changes in hepatic function tests were mild and transient. The rate of postoperative complications was higher in the group of patients with chronic hepatic disease (77.8 versus 11.8 percent, p < 0.005). Prolonged hepatic ischemia should not be considered a risk factor in patients with normal livers, whereas morbidity and mortality rates are seriously affected by the presence of chronic hepatic disease.
进行了26例肝切除术，血管钳夹时间超过1小时。持续常温缺血的平均时长为67.0±7.5分钟（均值的标准误差）（范围为60至85分钟）。14例患者采用单纯门静脉三联钳夹，12例采用肝血管阻断。超过80%的患者接受了广泛肝切除术。记录到1例术后死亡。8例患者出现严重并发症，包括1例肝衰竭。肝功能检查的术后变化轻微且短暂。慢性肝病患者组的术后并发症发生率更高（77.8%对11.8%，p<0.005）。对于肝脏正常的患者，不应将长时间肝缺血视为危险因素，而慢性肝病的存在会严重影响发病率和死亡率。
