Efficacy and Safety of Hepatectomy Performed with Intermittent Portal Triad Clamping with Low Central Venous Pressure

Abstract

Background. This retrospective study was designed to investigate the efficacy and safety of intermittent portal triad clamping (PTC) with low central venous pressure (CVP) in liver resections.Methods. Between January 2007 and August 2013, 115 patients underwent liver resection with intermittent PTC. The patients’ data were retrospectively analyzed.Results. There were 58 males and 57 females with a mean age of 55 years (±13.7). Cirrhosis was found in 23 patients. Resections were performed for malignant disease in 62.6% (n=72) and for benign disease in 37.4% (n=43). Major hepatectomy was performed in 26 patients (22.4%). Mean liver ischemia period was 27.1 min (±13.9). The mortality rate was 1.7% and the morbidity rate was 22.6%. Cumulative clamping time (t=3.61,P<0.001) and operation time (t=2.38,P<0.019) were significantly correlated with AST alterations (D-AST). Cumulative clamping time (t=5.16,P<0.001) was significantly correlated with D-ALT. Operation time (t=5.81,P<0.001) was significantly correlated with D-LDH.Conclusions. Intermittent PTC under low CVP was performed with low morbidity and mortality. Intermittent PTC can be safely applied up to 60 minutes in both normal and impaired livers.