In order to reduce intraoperative blood loss and prevent significant hemorrhages, laparoscopic liver resection (LLR) requires the use of an adequate bleeding management approach. It is still debatable whether total hepatic inflow occlusion (TIO) or hemihepatic inflow occlusion (HIO) is better for LLR. For a study, researchers sought to assess the perioperative results between HIO and TIO for LLR; they conducted a randomized controlled trial.

Patients who completed the requirements through surgical investigation in the operating theater were randomly divided into two groups from December 2017 to August 2019. Perioperative data from the two groups were recorded, compared, and subsequently analyzed by subgroup.

The TIO (n = 129) and HIO (n = 129) groups each had 258 patients. Regarding intraoperative blood loss, surgery duration, postoperative issues, modifications to postoperative liver function, and early death, there was no discernible difference between the two groups. But for patients whose transection plane was on the liver Cantlie’s plane, subgroup analysis results showed that TIO had a shorter operative time (median, 220 vs. 240 min, P = 0.030), occlusion time (median, 45 vs. 60 min, P = 0.011), and less intraoperative blood loss (median, 200 vs. 300 ml, P = 0.002) than HIO, whereas the morbidity

When carried out by qualified surgeons, the TIO and HIO techniques might both be used safely for LLR in specific individuals. The TIO method for LLR had the benefit of being simpler to learn than the HIO method. Additionally, TIO appears to have better perioperative results when the transection plane is on the liver of Cantlie’s plane.

Reference: sciencedirect.com/science/article/pii/S1743919122007385