Application of hepatic angiography with 3-D reconstruction plus regional blood flow occlusion and persistent methylene blue dyeing in precise hepatectomy
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R735.7

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    Abstract:

    Objective: To determine the application value of preoperative dual-source CT (DSCT) hepatic angiography with 3-D reconstruction plus intraoperative regional blood flow occlusion and persistent methylene blue dyeing in precise liver resection. Methods: Thirty-seven liver cancer patients underwent DSCT hepatic tumor angiography with 3-D reconstruction, followed by the surgical procedure that in order included dissection of the first hepatic hilum, exposure of each vessel enveloped by the sheath of Glisson’s capsule into the lobe or segments to be resected, methylene blue injection through the tributaries of the portal vein (or through the bile duct in cases with portal vein tumor thrombus) to the lobe or segments to be resected, and then occlusion of blood flow of the liver to be resected, and lobectomy or segmentectomy according to the boundary of methylene blue dyeing. These 37 patients (observational group) were compared with 32 liver cancer patients undergoing conventional liver resection (control group) during the same period. Results: In the 37 cases of observational group undergoing precise liver resection, the results of preoperative hepatic angiography were consistent with the views of intraoperative liver staining. Compared with control group, in observational group, the operative time was prolonged, but the blood loss during liver resection was reduced, the changes in liver function parameters were mild with quicker recovery, the incidence of postoperative complications was decreased and the length of hospital stay was shortened (all P<0.05). Conclusion: Using preoperative hepatic angiography and 3-D reconstruction plus persistent methylene blue dyeing and regional blood flow occlusion in precise liver resection can reduce bleeding, avoid injury of the vessels of Glisson’s system of the preserved liver tissue, and reduce the damage of liver function and surgical complications.

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CHEN Xiaoliang, WANG Chuanhong, SONG Zhi, XIAO Yuansheng, LIAO Chuanwen, RAO Xuefeng, CAO Hong, SHI Jun. Application of hepatic angiography with 3-D reconstruction plus regional blood flow occlusion and persistent methylene blue dyeing in precise hepatectomy[J]. Chin J Gen Surg,2015,24(7):1001-1006.
DOI:10.3978/j. issn.1005-6947.2015.07.015

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History
  • Received:September 18,2014
  • Revised:May 17,2015
  • Adopted:
  • Online: July 15,2015
  • Published: