The wound may require enlargement to visualize the source of bleeding by utilizing finger-fracture technique and retractors (hepatotomy). Bleeding vessels can be controlled using sutures, surgical clips, and electrocautery. However, deep stitches, which could lead to ischemic areas, should be avoided.
While a Pringle maneuver might be required, prolonged pedicle clamping must be avoided whenever possible as it may aggravate ischemic injury caused by hypotension. If pedicle clamping longer than 30min is needed, intermittent clamping is recommended (15min of clamping and 5min of reperfusion).
Hepatic defects can be filled by vascularized omentum (omentoplasty). This helps to eliminate dead space, tamponades venous oozing and may reduce the risk of a significant bile leakage.
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For centuries, ever since the legendary Ponce de Leon went searching for the elusive Fountain of Youth, people have been looking for ways to slow down the aging process. Medical science has made great strides in keeping people alive longer by preventing and curing disease, and helping people to live healthier lives. Average life expectancy keeps increasing, and most of us can look forward to the chance to live much longer lives than our ancestors.