The Usefulness of Intraoperative Continuous Monitoring of Hepatic Venous Hemoglobin Oxygen Saturation during Hepatopancreatoduodenectomy and Hepatectomy

Ryoko Sasaki, Masahiko Murakami, Nobuhiro Sato, Osamu Funato, Hiroyuki Nitta, Yutaka Shimada, Hidenobu Kawamura, Takayuki Suto, Senji Kanno*, Kazuyoshi Saito

Department of Surgery 1, Iwate Medical University School of Medicine
*Department of Surgery, Iwate Prefectural Senmaya Hospital

In order to reveal the usefulness of monitoring hepatic venous hemoglobin oxygen saturation (Shvo 2) during hetatopancreatoduodenectomy (HPD) and hepatectomy, intraoperative Shvo2 was measured and its relation to postoperative hepatic functions was investigated in 9 HPD patients and 13 hepatectomy patients. Shvo2 dropped during removal of the liver, Pringle's procedure and dissection of the lymph nodes especially around the hepatoduodenal ligament and superior mesenteric artery. The duration of Shvo2≤60% was 38.5+37.9 minutes in patients who underwent hepatectomy, and 60.0+52.7 minutes in those who underwent HPD. When the relationship between the duration of Shvo2≤60% and the postoperative peak serum bilirubin level was investigated, there were significant correlations in HPD+hepatectomy patients and HPD patients (p<0.01 and p<0.05, respectively). There were no significant correlations between duration of Shvo2≤60% and the postoperative arterial ketone body ratio. It is considered that Shvo2 reflects intraoperative hypoxic stress against the liver and is useful to predict postoperative hepatic failure.

Key words
hepatopancreatoduodenectomy, hepatectomy, hepatic venous hemoglobin oxygen saturation

Reprint requests
Ryoko Sasaki Department of Surgery I, Iwate Meical University, School of Medicine
19-1 Uchimaru, Morioka, 020-8505 JAPAN

Accepted
March 11, 1998

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