A comparative study oncontinuous hemihepatic with intermittent total hepatic inflow occlusion in hepatectomy forliver tumors

：Objective To evaluate ifcontinuous hemihepatic inflow occlusion(HH)during hepatectomy can be as safe and effectiveas intermittent total hepatic inflow occlusion(TH)in reducing blood loss duringhepatectomy.Methods From November 2001 to March 2006.eighty patients undergoing liverresections were included in a prospective randomized study comparning the intra-andpostoperative course underTH(n=40)or HH(n=40).TH was performed with periods of 20 minutesof occlusion and 5 minutes of releasing,while HH with continuous occlusion.The surfacearea of liver transection was measured and blood loss was calculated.The amount of bloodloss,levels of alanine aminotransferuse (ALT)and aspartate aminotransferase(AST),andpostoperative course were recorded. Results The total ischemic time of the HH groups waslonger than in the TH group[(42±13)min,(31±13)min,P=0.37],and the operative time in theHH group was longer than in the TH group[(236 ±49)min,(204±38)min,P=0.02 ].No signincantdifierenee was found between HH and TH group in blood loss during liver parenchymatransection[(500 ±269)ml,(416 ±235)ml,P=0.14]and in the changes of ALT and AST on thefirst postoperative day[ALT:(677±572)IU/L,(577 ±327)IU/L,P=0.12;AST:(591 ±468)IU/L,(512±301)IU/L,P=0.66].Therewere no difierences on postoperative morbidity between the two groups(22.5%versus20.0%,P=0.35).Conclusion The technique of continuous hemihepatic inflow occlusion is assafe and effective as intermittent total hepatic inflow occlusion.