A new blood controlling concept based on the dynamic liver blood watershed theory: cross interface blood control maneuver

Abstract

Liver is rich in blood supply, with soft and crisp texture, therefore its resection requires accurate and safe bleeding control techniques. The hemostatic effect of complete hepatic inflow occlusion is complete, but the side effects are comparatively serious and the blocking time is limited. The side effects of anatomical hepatic inflow occlusion are light, but there is more bleeding in the process of practice, especially the bleeding of the preserved side of the liver. Based on the dynamic watershed theory, there is traffic flow between hepatic segments and lobes, which is the reason for the poor effect of anatomic hepatic blood flow occlusion. We propose cross interface blood control maneuver. In this strategy, we use a variety of blood control methods alone or in combination, to control the borderline blood flow between segments/lobes. Therefore, compared with anatomic hepatic blood flow occlusion, this strategy can control bleeding well and reduce various side effects of total hepatic blood inflow occlusion.