Use of transportal balloon catheter occlusion of the portal triad in prevention of bleeding during liver resection

Meirav Sarely, Douglas B. Zippel, Moshe Koller, Adrian Valeanu, Danny Scott, Shlomo Ayalon, Gur Y. Ben Ari, Moshe Z. Papa

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Operative blood loss is among the most important factors determining the prognosis of patients undergoing hepatic resection. The best method for preventing bleeding is preliminary selective vascular occlusion of lobar, sectoral, or segmental portal triads, although not always technically feasible. Method: Transportal occlusion of the portal triad with a balloon catheter was used in 35 hepatectomies for various tumors. Results: In 27 out of 35 resections, there was absence or minimal bleeding from afferent vessels (portal vein, hepatic artery). In the remaining eight cases, there was significant bleeding from the hepatic artery. In these cases, transportal occlusion of portal triad was combined with a temporary interruption of the hepatic artery after the dissection of the hepatoduodenal ligament. The average intraoperative blood loss was 350-1,500 ml. Conclusion: The use of a balloon catheter occlusion of the portal triad during liver resection is often technically feasible. It facilitates temporary occlusion of hardly accessible portal veins in the hepatic hilus without their prior exposure and minimizes bleeding.

Original languageEnglish
Pages (from-to)39-42
Number of pages4
JournalJournal of Surgical Oncology
Volume89
Issue number1
DOIs
StatePublished - 1 Jan 2005
Externally publishedYes

Keywords

  • Balloon catheter occlusion
  • Hemostasis
  • Liver resection
  • Pringle maneuver

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