Techniques of Vascular Inflow Occlusion and Liver Parenchymal Transection

Abstract

Liver resection has experienced more than 100 years of development as the primary treatment for HCC. To the end of the nineteenth century, the animal experiment research had shown that liver parenchyma incision is feasible. When the liver had been cut off three quarters, the animal was still alive. In 1888, Langenbuch, a German surgeon, successfully resected a tumor on the edge of the liver in a woman patient. Therefore, he was regarded as the first person who succeeded in resecting liver tumors. William Keen (1899) was considered as the first American surgeon in liver resection; he reported three successful surgical cases. However, the perioperative mortality (70–90 %) of liver resection was very high during that period [1]. One of the main reasons was that the blood loss in the surgery could not be effectively controlled. The control of hemorrhage during liver resection is very important for HCC patients, especially with cirrhosis, because the amount of blood loss and transfusion in the operation have been shown to correlate with morbidity, mortality, and long-term survival after operation [2–4].