Trial Information

A Prospective Randomized Controlled Trial of Total Hemihepatic Vascular Exclusion in Hepatectomy in Hepatocellular Carcinoma Treatment

The amount of blood loss and blood transfusion in Hepatectomy have a detrimental effect on
the prognosis for Hepatocellular carcinoma(HCC).Intraoperative bleeding remains a major
concern during liver resection. The most often used hepatic vascular control methods at
present are hepatic pedicle occlusion(Pringle maneuver), hemihepatic vascular
clamping,segmental vascular clamping and total hepatic vascular exclusion (THVE).However,all
these methods have shortcomings. Pringle maneuver cannot prevent bleeding from hepatic veins
and leads to ischemia-reperfusion injury of the liver; Hemihepatic vascular clamping cannot
prevent bleeding from hepatic veins as well, and from the remnant (nonoccluded) liver. THVE
is a technically demanding technique that requires surgical and anesthetic expertise and may
lead to hemodynamic intolerance as well as increased morbidity and hospital stay. Total
hemihepatic vascular exclusion(THHVE),completely isolates the right or left hemiliver
ipsilateral to the lesion that requires resection from the systemic circulation,has the
advantage of preventing backflow hemorrhage or air embolism without having to resort to
caval blood flow interruption of THVE.

The purpose of this study is to evaluate if THHVE can raduce bleeding,reduce the incidence
of complications and improve the patient's free survival and overall survival compared with
other occlusion methods.