Study on Clinical Outcome of Vascular Inflow Occlusion in Open Liver Resection

Chinese University of Hong Kong126 enrolled

Overview

This study aims to evaluate whether applying inflow vascular occlusion in modern liver resection is associated with better clinical outcome. Eligible patients are randomly assigned to the two surgical techniques: with or without the application of inflow vascular occlusion. Patients outcome including liver function recovery, operative time and blood loss are compared.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

126

Conditions

Hepatectomy

Interventions

Intermittent Pringle maneuverPROCEDURE

Pringle maneuver is performed by isolation of the hepatoduodenal ligament which is then encircled and occluded with atraumatic vascular clamp. The clamp is applied for 15 minutes followed by unclamping for 5 minutes and repeated till end of liver transection. Limits of clamp cycle: 3 cycles for cirrhotic liver; 4 cycles for non-cirrhotic liver.

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Age \> 18 years * Child-Pugh Class A or B Exclusion Criteria: * Informed consent not available * Presence of portal vein thrombosis, portal vein tumor thrombus, or previous portal vein embolisation * Presence of hepatic artery thrombosis, previous transarterial therapy like TACE, or transarterial internal radiation * When portal vein resection is anticipated * Emergency hepatectomy * Ruptured hepatocellular carcinoma * Rehepatectomy (repeated liver resection) * Adhesion or anatomical variation that preclude safe and successful application of Pringle maneuver * When concomitant bowel or bile duct resection is anticipated

Locations (1)

Prince of Wales Hospital

Hong Kong, China

Outcomes

Primary Outcomes

Operative blood loss

Time frame: From skin incision to completion of operation

Operative time

Time frame: From skin incision to completion of operation

Secondary Outcomes

Operative morbidity and mortality

Time frame: From date of operation to 30-day after operation

Recovery of liver function

Time frame: From date of operation to date of discharge

Data from ClinicalTrials.gov

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