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Techniques to Minimize Blood Loss During Hepatectomy

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Optimizing Outcomes for Liver and Pancreas Surgery

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Abstract

The liver has such a rich blood supply and significant bleeding risk that it was thought by many including Galen, one of the most famous ancient Greek physicians, to be the source of venous blood. In the 1970s, observed operative mortality rates from hepatectomy procedures ranged from 17% to 24%. Comparatively, modern series show rates of mortality after hepatectomy of around 5% or significantly less. Risk factors associated with operative mortality after partial hepatectomy include operative blood loss and transfusion requirement. Bleeding and blood transfusions may even increase the risk of recurrence after hepatectomy for malignant diseases. Thus, reducing operative blood loss is of paramount importance. Many techniques exist for attempting to reduce operative blood loss during partial hepatectomy; however, the best techniques to reduce blood loss have been difficult to determine and great controversy persists. This chapter will focus on the current techniques to reduce blood loss during hepatectomy and provide recommendations.

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  1. Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA

    Justin T. Huntington MD, MS & Carl R. Schmidt MD, MS

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  1. Justin T. Huntington MD, MS
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Correspondence to Carl R. Schmidt MD, MS .

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  1. Virginia Mason Medical Center, Seattle, Washington, USA

    Flavio G. Rocha

  2. Wake Forest Baptist Health, Winston-Salem, North Carolina, USA

    Perry Shen

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Huntington, J.T., Schmidt, C.R. (2018). Techniques to Minimize Blood Loss During Hepatectomy. In: Rocha, F., Shen, P. (eds) Optimizing Outcomes for Liver and Pancreas Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-62624-6_5

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