Elias D, Lasser P, Debaene B, Doidy L, Billard V, Spencer A, Leclercq B
Service de Chirurgie Digestive Carcinologique, Institut Gustave Roussy, Villejuif, France.
Br J Surg. 1995 Nov;82(11):1535-9. doi: 10.1002/bjs.1800821126.
Intermittent vascular exclusion of the liver (IVEL) combines clamping of the hepatic pedicle with clamping of the main hepatic veins without interruption of caval flow. In this retrospective study, eight cases of total IVEL and eight of partial IVEL were analysed (involving only the middle and left hepatic veins) during major hepatectomy for malignant tumours. Liver parenchyma was pathological in nine cases. IVEL was feasible in 16 of the 18 attempts and was efficient in reducing bleeding during hepatectomy in 15 cases. Mean duration of IVEL was 60.2 (range 37-140) min, mean blood loss was 1230 (range 300-2800) ml and there were no postoperative complications related to the procedure. The major advantages of this technique of liver vascular exclusion (good tolerance and possibility of long duration) merit its inclusion in the list of different clamping techniques available for use during hepatectomy.
间歇性肝脏血管阻断术（IVEL）是将肝蒂阻断与肝主静脉阻断相结合，同时不中断腔静脉血流。在这项回顾性研究中，分析了8例全肝IVEL和8例部分肝IVEL（仅涉及肝中静脉和肝左静脉）用于恶性肿瘤大肝切除术的情况。9例患者的肝实质存在病理改变。18次尝试中有16次IVEL可行，15例患者在肝切除术中IVEL有效减少了出血。IVEL的平均持续时间为60.2（范围37 - 140）分钟，平均失血量为1230（范围300 - 2800）毫升，且无与该手术相关的术后并发症。这种肝脏血管阻断技术的主要优点（耐受性好且可长时间阻断）使其值得被列入肝切除术可用的不同阻断技术列表中。
