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- W2894565514 abstract "Introduction: Small for size syndrome (SFSS) is a serious complication of extended hepatectomy. The relationship between high portal pressure and SFSS has been clearly demonstrated insomuch that some authors refer to it as “small for flow” syndrome. We present our experience with portal inflow modulation by somatostatin in tourniquet ALPPS Methods: We calculated the portal vein flow (PVF) by intraoperative ultrasound during Tourniquet ALPPS procedure. We established 2 groups: patients with portal flow lower than 17 cm/sec and those with flow higher than 17 cm/sec. In the latter case we started portal inflow modulation intraoperatively by intravenous administration of somatostatin and we maintained it for 3 days. Results: The PVF was measured in 35 patients. At the end of the stage 1, PVF was higher than 17 cm/sec in 6 cases (17%) and somatostatin was initiated. At the beginning of Stage 2, PVF was > 17 cm/sec in 6 patients After ligation of the right hepatic artery 11 patients (31%) presented a PVF > 17 cm/sec, which was maintained until 30 minutes after finishing the major hepatectomy (19 right trisectionectomy and 16 right hepatectomy). After starting somatostatin perfusion, PVF decrease below 17 cm/sec in 9 patients. In 2 cases ligation of the splenic artery was necessary. 5 patients presented postoperative liver failure (POLF) (14.3%): 4 within the group of patients with high PVF treated with somatostatin (2 of them died). Conclusion: Somatostatin could be useful to decrease portal flow in major liver resections." @default.
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- W2894565514 date "2018-09-01" @default.
- W2894565514 modified "2023-10-17" @default.
- W2894565514 title "Portal inflow modulation by somatostatin during tourniquet ALPPS" @default.
- W2894565514 doi "https://doi.org/10.1016/j.hpb.2018.06.2919" @default.
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