To evaluate the effect on liver due to repeated total hepatic inflow occlusion with Pringle maneuver during liver resection, we analyzed changes in hepatic venous blood of the remaining liver in 16 patients undergoing partial hepatectomy. These patients were divided into two groups as follows : chronic liver disease group consisted of the patients with cirrhosis and/or chronic hepatitis, and normal liver group consisted of the patients with no any chronic liver disease.
No significant decreases were found in oxygen saturation (SvO
2) between before the first clamping and 15 min after that in both group. Although HVKBR and AKBR decreased significantly 15 min after the first clamping in the chronic liver disease group, they return to the initial levels within the following 5 min of declamping.
No significant differences were found in SvO
2, lipid peroxide, HVKBR and AKBR between before the first clamping and 5 min after the final declamping in both groups. However, pH and HCO
3-significantly decreased and PvCO
2 significantly increased 5 min after the final declamping in the chronic liver disease group.
These results suggested that intermittent total hepatic inflow occlusion during liver surgery induces negligible or no liver damage in the patients with chronic liver disease. However, this procedure may induce a significant metabolic acidosis in these patients.
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