<p>This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</p> <p>Limited resection can be a therapeutic approach in patients with cirrhosis with very low
remnant hepatic function after resection. In this study, two hilar vascular clamping
methods (hilar selective clamping [<italic>n</italic>=13] and hilar lobar clamping method [<italic>n</italic>=8]), which were used for resection ofhepatocellular carcinoma in patients with cirrhosis, were
compared based on cardiovascular stability during clamping, intraoperative bleeding,
operative time and postoperative course. In the past, the Pringle method had been used
(<italic>n</italic>=19) and those instances were included for comparison. The mean operation time of
the lobar clamping group was 209 ± 44 minutes, which was significantly less than that of
the selective clamping group (259 ± 44 minutes, <italic>p</italic> &lt; 0.05). Furthermore, the mean
intraoperative blood loss of the lobar clamping group was 920 ± 400 milliliters, which
was significantly less than that of the selective clamping group (1,640 ± 590 milliliters,
<italic>p</italic> &lt; 0.01). The postoperative total bilirubin and glutamine-oxaloacetic transaminase
levels tended to be high in the Pringle group, but there was no significant difference
between the groups. Although the blood pressure during clamping significantly decreased
in all groups, the decrease was profound in the Pringle group as compared with those in
the other two groups. Thus, as a method for controlling afferent bloodflow during hepatic
resection in patients with cirrhosis, we recommend the lobar clamping method as a
simple, safe and effective way to minimize bleeding and maintain cardiovascular
stability.</p>
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HPB Surg. 1996; 9(3):188-189