This clinical trial aims to compare infrahepatic inferior vena cava clamping (IIVCC) with selective hepatic vascular exclusion (SHVE) involving the portal triad clamping (PTC) in complex cirrhotic liver resection. One group will receive IIVCC plus PTC, while an another equivalent group patients will be operated using SHVE and PTC.
Intraoperative blood loss is significantly associated with clinical outcomes of patients undergoing hepatectomy. There have been various hepatic vascular control techniques, including infrahepatic inferior vena cava clamping (IIVCC) and selective hepatic vascular exclusion (SHVE).The propose of this study is to compare these two surgical techniques combined with the portal triad clamping (PTC) in hepatic cirrhotic patients. All patients being performed hepatectomy at the center are scanned according to inclusion and exclusion criteria. After intraoperative exploration, patients are randomized into two interventional groups. PTC, IIVCC or SHVE is performed at the specified timepoint in liver parenchymal transection in two different groups. All data are collected prospectively.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
120
Infrahepatic inferior vena cava is clamped in hepatectomy.
Selected major hepatic vein is clamped in hepatectomy.
Portal triad are clamped in hepatectomy.
Tongji Hospital
Wuhan, Hubei, China
RECRUITINGIntraoperative blood loss
blood loss from incision to closure
Time frame: Intraoperative period
Normalized transection-related blood loss
Intraoperative blood loss normalized by transection surface area
Time frame: Intraoperative period
Time of infrahepatic inferior vena cava or selected hepatic vein dissection
Time cost of dissection
Time frame: Intraoperative period
Variations of intraoperative infrahepatic inferior vena cava pressure or hepatic vein pressure
Time frame: Intraoperative period
Drop of hemoglobin level
Time frame: Drop of hemoglobin level will be measured during liver parenchymal transection period(neither the specific time point nor expected average could be given prospectively because of different surgical situations)
Postrecovery of liver function
Liver function evaluation is composite of liver enzyme ,total bilirubin, prothrombin activity, etc.
Time frame: postoperative days 1, 3, 5, 7
Postrecovery of renal function
Renal function evaluation is composite of blood urea nitrogen, creatinine, etc.
Time frame: postoperative days 1, 3, 5, 7
Morbidity of postoperative complications
Time frame: 90 days after surgery
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Postoperative mortality
Time frame: 90 days after surgery