Anatomic and Physiologic Basis of Liver Vascular Clamping
VASCULAR CLAMPING TECHNIQUES: Inflow Occlusion
Selective Clamping: Major Hepatectomy, Sectorial, or Segmental
Intraglissonian Dissection and Clamping
Suprahilar Dissection and Clamping
The Role of Central Venous Pressure
Vascular Clamping During Laparoscopic Liver Resection
VASCULAR CLAMPING TECHNIQUES: Outflow Occlusion
Total Vascular Exclusion of the Liver (TVE)
Hepatic Vascular Exclusion with Preservation of the Caval Flow (HVEPC)
Hepatic Tolerance to Vascular Clamping
Methods to Reduce Ischemic Injury: Intermittent Clamping
Ischemic Preconditioning (IPC)
Appendix 1: Indications for selective clamping
Unilateral lesions, especially in cases of projected major hepatectomy.
It is possible to combine and to alternate right and left clamping in cases of lesions located in both hepatic lobes.
Suprahilar clamping of a sectoral pedicle is more appropriate in cases of bisegmentectomy 5-8 than in cases of right posterior resection (segments 6 and 7).
Appendix 2: Indications for TVE
Patients with right-sided heart failure
Pulmonary artery hypertension
Tricuspid valve insufficiency