Xiaolin Wei1, Wenjing Zheng1, Zhiqing Yang2, Hui Liu1, Tengqian Tang2, Xiaowu Li1* and Xiangde Liu2
1Shenzhen University General Hospital & Shenzhen University Clinical Medical Academy, China
2Southwest Hospital, Third Military Medical University (Army Medical University), China
Background: The Pringle Maneuver (PM) interrupts the blood flow through the hepatic artery and the portal vein to help control bleeding. This study analyzes the effects of the Intermittent Pringle Maneuver (IPM) on the surgical process and the liver function recovery.Methods: This case-control study retrospectively evaluated 257 patients who underwent hepatectomy. In the IPM group, the hepatic vascular flow was intermittently clamped, with cycles of 10 minutes of inflow occlusion followed by 5 minutes of reperfusion that were repeated until the end of the surgery. In the non-IPM group, liver resection was performed without hepatic blockage.
Results: Surgery with IPM has advantages over surgery without IPM in terms of operation time and bleeding volume. The postoperative hospitalization time and ICU time were significantly lower in the IPM group than in the non-IPM group. The first day after the operation, the level of aspartate amino transferase (AST, p=0.0221), the level of total bilirubin (p=0.0171), the pro Thrombin Time (PT, p=0.0257), and the Activated Partial Thromboplastin Time (APTT, p=0.0063) were significantly higher in the non-IPM group than in the IPM group.Conclusion: The IPM does not negatively affect postoperative liver function recovery; the use of the IPM results in shorter operation times, lower bleeding volumes, and shorter hospital and ICU stays compared to surgeries without the use of the IPM.
Hepatectomy; Pringle maneuver; Liver function; Retrospective; Clinic
Wei X, Zheng W, Yang Z, Liu H, Tang T, Li X, et al. Effect of the Intermittent Pringle Maneuver on Residual Liver Function after Hepatectomy: A Retrospective Case-Controlled Study. Clin Surg. 2018; 3: 2247.