Normothermic total hepatic vascular exclusion for hepatectomy

Experience of normothermic total hepatic vascular exclusion for hepatectomy in two patients with hepatocarcinoma in the second porta hepatis area are reported. The combined method of stepwise exclusion of porta hepatis, total hepatic vascular exclusion, total hepatic vascular exclusion without abdominal aorta and manipulative exclusion of inferior vena cava above liver are described. Biochemical studies before, during and after the operation showed that they are similar to these of routine hepatectomy. This modification, being safer and easier, may increase the resectability and reduce the mortality rate.