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Effect of the intermittent Pringle maneuver on liver damage after hepatectomy: a retrospective cohort study
BACKGROUND: The Pringle maneuver (PM) interrupts the blood flow through the hepatic artery and portal vein to help control bleeding. This study analyzes the effects of the intermittent Pringle maneuver (IPM) on the surgical process and postoperative liver injury. METHODS: This study retrospectively...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6693131/ https://www.ncbi.nlm.nih.gov/pubmed/31409370 http://dx.doi.org/10.1186/s12957-019-1680-y |
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author | Wei, Xiaolin Zheng, Wenjing Yang, Zhiqing Liu, Hui Tang, Tengqian Li, Xiaowu Liu, Xiangde |
author_facet | Wei, Xiaolin Zheng, Wenjing Yang, Zhiqing Liu, Hui Tang, Tengqian Li, Xiaowu Liu, Xiangde |
author_sort | Wei, Xiaolin |
collection | PubMed |
description | BACKGROUND: The Pringle maneuver (PM) interrupts the blood flow through the hepatic artery and portal vein to help control bleeding. This study analyzes the effects of the intermittent Pringle maneuver (IPM) on the surgical process and postoperative liver injury. METHODS: This study retrospectively evaluated 182 hepatocellular carcinoma patients who underwent hepatectomy. In the IPM group, hepatic blood flow was intermittently interrupted via clamping, 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 vascular blockage. RESULTS: For postoperative complications, the incidence rates of ascites and pleural effusion in the IPM group were significantly lower than those in the non-IPM group. The postoperative hospitalization time in the IPM group was significantly lower than that in the non-IPM group (p=0.0008). On the first day after the operation, the platelet count was significantly lower (p=0.0381) but the prothrombin time (PT) (p=0.0195) and activated partial thromboplastin time (APTT) (p=0.0071) were significantly higher in the non-IPM group than those in the IPM group. At discharge, only albumin was significantly higher in the non-IPM group than that in the IPM group (p=0.0303). Regression analysis showed that a prolonged interruption time was related to increased ALT and AST levels on the first day after surgery, but not on the seventh day or at discharge. CONCLUSION: The IPM does not cause additional liver damage during hepatectomy, and use of the IPM results in shorter hospital stays compared to surgery without using the IPM. The results of this study require further confirmation because of the retrospective design. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12957-019-1680-y) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-6693131 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-66931312019-08-16 Effect of the intermittent Pringle maneuver on liver damage after hepatectomy: a retrospective cohort study Wei, Xiaolin Zheng, Wenjing Yang, Zhiqing Liu, Hui Tang, Tengqian Li, Xiaowu Liu, Xiangde World J Surg Oncol Research BACKGROUND: The Pringle maneuver (PM) interrupts the blood flow through the hepatic artery and portal vein to help control bleeding. This study analyzes the effects of the intermittent Pringle maneuver (IPM) on the surgical process and postoperative liver injury. METHODS: This study retrospectively evaluated 182 hepatocellular carcinoma patients who underwent hepatectomy. In the IPM group, hepatic blood flow was intermittently interrupted via clamping, 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 vascular blockage. RESULTS: For postoperative complications, the incidence rates of ascites and pleural effusion in the IPM group were significantly lower than those in the non-IPM group. The postoperative hospitalization time in the IPM group was significantly lower than that in the non-IPM group (p=0.0008). On the first day after the operation, the platelet count was significantly lower (p=0.0381) but the prothrombin time (PT) (p=0.0195) and activated partial thromboplastin time (APTT) (p=0.0071) were significantly higher in the non-IPM group than those in the IPM group. At discharge, only albumin was significantly higher in the non-IPM group than that in the IPM group (p=0.0303). Regression analysis showed that a prolonged interruption time was related to increased ALT and AST levels on the first day after surgery, but not on the seventh day or at discharge. CONCLUSION: The IPM does not cause additional liver damage during hepatectomy, and use of the IPM results in shorter hospital stays compared to surgery without using the IPM. The results of this study require further confirmation because of the retrospective design. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12957-019-1680-y) contains supplementary material, which is available to authorized users. BioMed Central 2019-08-13 /pmc/articles/PMC6693131/ /pubmed/31409370 http://dx.doi.org/10.1186/s12957-019-1680-y Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Wei, Xiaolin Zheng, Wenjing Yang, Zhiqing Liu, Hui Tang, Tengqian Li, Xiaowu Liu, Xiangde Effect of the intermittent Pringle maneuver on liver damage after hepatectomy: a retrospective cohort study |
title | Effect of the intermittent Pringle maneuver on liver damage after hepatectomy: a retrospective cohort study |
title_full | Effect of the intermittent Pringle maneuver on liver damage after hepatectomy: a retrospective cohort study |
title_fullStr | Effect of the intermittent Pringle maneuver on liver damage after hepatectomy: a retrospective cohort study |
title_full_unstemmed | Effect of the intermittent Pringle maneuver on liver damage after hepatectomy: a retrospective cohort study |
title_short | Effect of the intermittent Pringle maneuver on liver damage after hepatectomy: a retrospective cohort study |
title_sort | effect of the intermittent pringle maneuver on liver damage after hepatectomy: a retrospective cohort study |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6693131/ https://www.ncbi.nlm.nih.gov/pubmed/31409370 http://dx.doi.org/10.1186/s12957-019-1680-y |
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