Abstract
Objective To summarize the experience in managing hepatic cutting surface in hepa-tectomy. Methods Fifty-eight receiving hepatectomy were divided into 3 groups according to the condition of the hepatic cutting surface. The hepatic cutting surface was open and managed with application of stypic powder in group A, open and cauterized by argon bistoury in group B and sutured in group C. The hemorrhage volume of wound surface, hemostasis time-consumption in operation and drainage volume, hepatic function after operation were determined and compared among the 3 groups. Results There were no significant differences among the 3 groups in age, sex, tumor size, method of hepatic portal blockage, blockage time, portal vein cancer embolus, wound surface drainage volume after operation, hepatitis immunity, blood routine, prothrombin time, AFP, albumin, pre-albumin, globumin and bilirubin (P>0.05). However, the hemorrhage volume of wound surface was signifi-cantly less in group A and C than in group B (P 0.05). Meanwhile, the change in GPT was remarkably lower in group A and B than in group C 24 h, 3 d and 7 d after operation (P<0.05). But there was no significant difference between group A and B. Conclusion The management of hepatic cutting surface will directly affect hemorrhage volume and liver function. To avoid hemorrhage, we can apply stypic powder or other he-mostatic or suture hepatic cutting surface. To avoid hepatic failure, we can make the cutting surface open to lessen the damage of remain liver. However, the best method for preventing hemorrhage and hepatic failure is to make the cutting surface open and apply stypic powder or other hemostatics. We should choose the three methods flexibly according to patients economic and pathological conditions. Key words: Hepatectomy; Cutting surface management; MPH; Hemostasis; Liver function; ALT
Published Version
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