Abstract
Hepatic oxygen status was monitored by hepatic venous oxygen saturation (ShVO2) in 11 patients who underwent hepatic lobectomy. Fiberoptic pulmonary catheters (7.5Fr) were placed into the hepatic vein before anesthesia. Eight patients showed a marked decrease in ShVO2 during temporary occlusion of the hepatic artery and portal vein, with a correlated rise in arterial lactate concentration (r=0.66, p<0.01) indicating hep-atocellular hypoxia, and a rise in postoperative GOT and GPT. Meanwhile in the remaining 3 patients, little or no changes in ShVO2 were observed during temporary cessation of hepatic blood flow suggesting the catheter tip was placed into the unresect-ed hepatic lobe.
We concluded that ShVO2 is a valuable indicator when continuously monitoring hepatic oxygen status during a hepatectomy, and that intraoperative decreases in ShVO2 are likely to be related to postoperative hepatic dysfunction. Placement of the catheter tip should be carefully selected according to anatomy of the liver, resected side or unresected side.
