Pringle's Maneuver Versus Selective Hepatic Vascular Exclusion in Hepatectomy About Recurrence and Survival :A Prospective Randomized Trial
Hepatocellular carcinoma (HCC), a serious disease with high incidence at home and abroad
still shows a rising trend. In recent decade, the overall survival rate of the disease has
entered a platform stage with little advance despite diversified methods of treatment. The
prognosis of HCC is not so satisfying.
Intraoperative bleeding remains a major concern during liver resection. Blood loss usually
occurs during parenchymal transection and reperfusion after Pringle's maneuver. The amount
of blood loss and the need for blood transfusion have a detrimental effect on the short- and
Portal triad clamping is sufficient in most situations to control bleeding during
hepatectomy. However, it does not prevent backflow bleeding from hepatic veins, which may
become troublesome or even hazardous. This is particularly true in tumors that are large or
that have invaded into the branches of the major hepatic veins.
SHVE completely isolates the liver from the systemic circulation with the advantage of
preventing backflow hemorrhage or air embolism without having to resort to caval blood flow
interruption of THVE.
The purpose of the study is to assess the risk factors for the recurrence and metastasis in
HCC patients undergoing hepatectomy by SHVE and to evaluate that SHVE can improve survival
in HCC patients or not.
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
1,2,or 3 years
Feng Shen, M.D.
Eastern Hepatobiliary Surgery Hospital, Second Military Medical University
China: Ministry of Health