Randomized clinical trial of liver resection with and without hepatic pedicle clamping

Abstract

Background: The purpose of this study was to compare the perioperative outcome of liver resection with and without intermittent hepatic pedicle clamping. Methods: Between June 2002 and June 2004, 126 consecutive patients with resectable liver tumours were randomized to undergo resection with (63 patients) or without (63 patients) intermittent hepatic pedicle clamping. Results: The transection time was significantly higher in the group without hepatic pedicle clamping. The blood loss per cm2 was similar in the two groups: 2-7 ml/cm2 in the group with versus 3-2 ml/cm2 in group without hepatic pedicle clamping (P = 0.425). In the subset of patients with an abnormal liver, there were no differences in blood loss per transection surface: 3-1 ml/cm2 in the group with versus 2.9 ml/cm2 in the group without clamping (P = 0.829). The rate of blood transfusions was not higher in the non-clamping group. No differences were observed in the postoperative liver enzyme serum levels, the in-hospital mortality (one patient in each group) or the number of complications. Conclusion: This study showed clearly that liver resection without hepatic pedicle clamping is safe, even in patients with a diseased liver. Copyright © 2006 British Journal of Surgery Society Ltd.