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Bleeding in Hepatic Surgery Sorting through Methods to Prevent It英文文献资料.doc

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Bleeding in Hepatic Surgery Sorting through Methods to Prevent It英文文献资料

HindawiPublishingCorporation HPBSurgery Volume2012,ArticleID169351,12pages doi:10.1155/2012/169351 ReviewArticle BleedinginHepaticSurgery:Sortingthrough MethodstoPreventIt FabrizioRomano,MattiaGarancini,FabioUggeri,LucaDegrate,LucaNespoli, LucaGianotti,AngeloNespoli,andFrancoUggeri UnitofHepatobiliaryandPancreaticSurgery,DepartmentofSurgery,SanGerardoHospital,UniversityofMilan-Bicocca, ViaDonizetti106,20052Monza,Italy CorrespondenceshouldbeaddressedtoFabrizioRomano,fabrizio.romano@unimib.it Received4June2012;Accepted23October2012 AcademicEditor:AndreaLauterio Copyright?2012FabrizioRomanoetal. This is an open access article distributed under the Creative Commons Attribution License,whichpermitsunrestricteduse,distribution,andreproductioninanymedium,providedtheoriginalworkisproperly cited. Liver resections are demanding operations which can have life threatening complications although they are performed by experiencedliversurgeons.Theparameter“BloodLoss”hasacentralroleinliversurgery,anddi?erentstrategiestominimize itareakeytoimproveresults.Moreover,recently,newtechnologiesareappliedinthe?eldofliversurgery,havingonegoal:safer andeasierliveroperations.Theaimofthispaperistoreviewthedi?erentprincipalsolutionstotheproblemofbloodlossin hepaticsurgery,focusingontechnicalaspectsofnewdevices. 1.Introduction with a higher rate of perioperative transfusions; and host immunosuppression associated with transfusions with a dose-related relationship is correlated with a higher rate of complication (in particular infections) and recurrence of malignancies in neoplastic patients [11, 12, 14–21]. In ordertoreducetransfusions,hepaticsurgeonhasalsonotto misinterpretpostoperative?uctuationsofbloodparameter: Torzilli et al. demonstrated that haemoglobin rate and haematocritafterliverresectionshowasteadyandsigni?cant decrease until the third postoperative day and then an increase,sothissituationhastobeexplainedasphysiological anddoesnotjusti?esbloodadministration[22]. Liverresectionisc