Infrahepatic Inferior Vena Cava Clamping Reduces Blood Loss during Liver Transection for Cholangiocarcinoma

Background. Major hepatectomy is the mainstay of the treatment for cholangiocarcinoma. Infrahepatic inferior vena cava (IVC) clamping is an effective maneuver for reducing blood loss during liver transection. The impact of this procedure on major hepatectomy for cholangiocarcinoma is unknown. This s...

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Main Authors: Natwutpong Leeratanakachorn, Vor Luvira, Theerawee Tipwaratorn, Suapa Theeragul, Apiwat Jarearnrat, Attapol Titapun, Tharatip Srisuk, Supot Kamsa-ard, Ake Pugkhem, Narong Khuntikeo, Chawalit Pairojkul, Vajarabhongsa Bhudhisawasdi
Format: Article
Language:English
Published: Wiley 2021-01-01
Series:International Journal of Hepatology
Online Access:http://dx.doi.org/10.1155/2021/1625717
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author Natwutpong Leeratanakachorn
Vor Luvira
Theerawee Tipwaratorn
Suapa Theeragul
Apiwat Jarearnrat
Attapol Titapun
Tharatip Srisuk
Supot Kamsa-ard
Ake Pugkhem
Narong Khuntikeo
Chawalit Pairojkul
Vajarabhongsa Bhudhisawasdi
author_facet Natwutpong Leeratanakachorn
Vor Luvira
Theerawee Tipwaratorn
Suapa Theeragul
Apiwat Jarearnrat
Attapol Titapun
Tharatip Srisuk
Supot Kamsa-ard
Ake Pugkhem
Narong Khuntikeo
Chawalit Pairojkul
Vajarabhongsa Bhudhisawasdi
author_sort Natwutpong Leeratanakachorn
collection DOAJ
description Background. Major hepatectomy is the mainstay of the treatment for cholangiocarcinoma. Infrahepatic inferior vena cava (IVC) clamping is an effective maneuver for reducing blood loss during liver transection. The impact of this procedure on major hepatectomy for cholangiocarcinoma is unknown. This study evaluated the effect of infrahepatic IVC clamping on blood loss during liver transection. Methods. Clinical and pathological data were collected retrospectively for 116 cholangiocarcinoma patients who underwent major hepatectomy between January 2015 and December 2016, to investigate the benefit of infrahepatic IVC clamping. Two of five surgeons adapted the policy performing infrahepatic IVC clamping during liver transection in all cases. Patients, therefore, were divided into those (n=39; 33.6%) who received infrahepatic IVC clamping during liver transection (C1) and those (n=77; 66.4%) who did not (C0). Results. The patients’ backgrounds, operative parameters, and extent of hepatectomy did not differ significantly between the 2 groups, except for gender. A significantly lower blood loss (p=0.028), blood transfusion (p=0.011), and rate of vascular inflow occlusion requirement (p<0.001) were observed in the C1 group. The respective blood losses in the C1 group and the C0 group were 498.9 (95% CI: 375.8-622.1) and 685.6 (95% CI: 571-800.2) millilitres. Conclusions. The current study found infrahepatic IVC clamping during liver transection for cholangiocarcinoma reduces blood loss, blood transfusion, and rate of vascular inflow occlusion requirement.
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spelling doaj-art-fd89def677784dff92a5ad2a15a10a132025-02-03T01:25:17ZengWileyInternational Journal of Hepatology2090-34482090-34562021-01-01202110.1155/2021/16257171625717Infrahepatic Inferior Vena Cava Clamping Reduces Blood Loss during Liver Transection for CholangiocarcinomaNatwutpong Leeratanakachorn0Vor Luvira1Theerawee Tipwaratorn2Suapa Theeragul3Apiwat Jarearnrat4Attapol Titapun5Tharatip Srisuk6Supot Kamsa-ard7Ake Pugkhem8Narong Khuntikeo9Chawalit Pairojkul10Vajarabhongsa Bhudhisawasdi11Department of Surgery, Faculty of Medicine, Khon Kaen University, 123 Mittraparp Road, Meaung District, Khon Kaen 40002, ThailandDepartment of Surgery, Faculty of Medicine, Khon Kaen University, 123 Mittraparp Road, Meaung District, Khon Kaen 40002, ThailandDepartment of Surgery, Faculty of Medicine, Khon Kaen University, 123 Mittraparp Road, Meaung District, Khon Kaen 40002, ThailandDepartment of Surgery, Faculty of Medicine, Khon Kaen University, 123 Mittraparp Road, Meaung District, Khon Kaen 40002, ThailandDepartment of Surgery, Faculty of Medicine, Khon Kaen University, 123 Mittraparp Road, Meaung District, Khon Kaen 40002, ThailandDepartment of Surgery, Faculty of Medicine, Khon Kaen University, 123 Mittraparp Road, Meaung District, Khon Kaen 40002, ThailandDepartment of Surgery, Faculty of Medicine, Khon Kaen University, 123 Mittraparp Road, Meaung District, Khon Kaen 40002, ThailandDepartment of Epidemiology and Biostatistics, Faculty of Public Health, Khon Kaen University, 123 Mittraparp Road, Meaung District, Khon Kaen 40002, ThailandDepartment of Surgery, Faculty of Medicine, Khon Kaen University, 123 Mittraparp Road, Meaung District, Khon Kaen 40002, ThailandDepartment of Surgery, Faculty of Medicine, Khon Kaen University, 123 Mittraparp Road, Meaung District, Khon Kaen 40002, ThailandDepartment of Pathology, Faculty of Medicine, Khon Kaen University, 123 Mittraparp Road, Meaung District, Khon Kaen 40002, ThailandDepartment of Surgery, Faculty of Medicine, Khon Kaen University, 123 Mittraparp Road, Meaung District, Khon Kaen 40002, ThailandBackground. Major hepatectomy is the mainstay of the treatment for cholangiocarcinoma. Infrahepatic inferior vena cava (IVC) clamping is an effective maneuver for reducing blood loss during liver transection. The impact of this procedure on major hepatectomy for cholangiocarcinoma is unknown. This study evaluated the effect of infrahepatic IVC clamping on blood loss during liver transection. Methods. Clinical and pathological data were collected retrospectively for 116 cholangiocarcinoma patients who underwent major hepatectomy between January 2015 and December 2016, to investigate the benefit of infrahepatic IVC clamping. Two of five surgeons adapted the policy performing infrahepatic IVC clamping during liver transection in all cases. Patients, therefore, were divided into those (n=39; 33.6%) who received infrahepatic IVC clamping during liver transection (C1) and those (n=77; 66.4%) who did not (C0). Results. The patients’ backgrounds, operative parameters, and extent of hepatectomy did not differ significantly between the 2 groups, except for gender. A significantly lower blood loss (p=0.028), blood transfusion (p=0.011), and rate of vascular inflow occlusion requirement (p<0.001) were observed in the C1 group. The respective blood losses in the C1 group and the C0 group were 498.9 (95% CI: 375.8-622.1) and 685.6 (95% CI: 571-800.2) millilitres. Conclusions. The current study found infrahepatic IVC clamping during liver transection for cholangiocarcinoma reduces blood loss, blood transfusion, and rate of vascular inflow occlusion requirement.http://dx.doi.org/10.1155/2021/1625717
spellingShingle Natwutpong Leeratanakachorn
Vor Luvira
Theerawee Tipwaratorn
Suapa Theeragul
Apiwat Jarearnrat
Attapol Titapun
Tharatip Srisuk
Supot Kamsa-ard
Ake Pugkhem
Narong Khuntikeo
Chawalit Pairojkul
Vajarabhongsa Bhudhisawasdi
Infrahepatic Inferior Vena Cava Clamping Reduces Blood Loss during Liver Transection for Cholangiocarcinoma
International Journal of Hepatology
title Infrahepatic Inferior Vena Cava Clamping Reduces Blood Loss during Liver Transection for Cholangiocarcinoma
title_full Infrahepatic Inferior Vena Cava Clamping Reduces Blood Loss during Liver Transection for Cholangiocarcinoma
title_fullStr Infrahepatic Inferior Vena Cava Clamping Reduces Blood Loss during Liver Transection for Cholangiocarcinoma
title_full_unstemmed Infrahepatic Inferior Vena Cava Clamping Reduces Blood Loss during Liver Transection for Cholangiocarcinoma
title_short Infrahepatic Inferior Vena Cava Clamping Reduces Blood Loss during Liver Transection for Cholangiocarcinoma
title_sort infrahepatic inferior vena cava clamping reduces blood loss during liver transection for cholangiocarcinoma
url http://dx.doi.org/10.1155/2021/1625717
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