Background: The Pringle maneuver is often used in liver surgery to minimize bleeding during liver transection. Many authors have demonstrated that intermittent use of the Pringle maneuver is safe and effective when performed appropriately. However, some studies have reported that the Pringle maneuver is a significant risk factor for portal vein thrombosis. In this study, we evaluated the effectiveness of portal vein flow after the Pringle maneuver and the impact that massaging the hepatoduodenal ligament after the Pringle maneuver has on portal vein flow.
Materials And Methods: Patients treated with the Pringle maneuver for hepatectomies performed to treat hepatic disease at our hospital between August 2014 and March 2019 were included in the study (N = 101). We divided these patients into two groups, a massage group and nonmassage group. We measured portal vein blood flow with ultrasonography before and after clamping of the hepatoduodenal ligament. We also evaluated laboratory data after the hepatectomy.
Results: Portal vein flow was significantly lower after the Pringle maneuver than before clamping of the hepatoduodenal ligament. The portal vein flow after the Pringle maneuver was improved following massage of the hepatoduodenal ligament. After hepatectomy, serum prothrombin time was significantly higher and serum C-reactive protein was significantly lower in the massage group than in the nonmassage group.
Conclusion: Massaging the hepatoduodenal ligament after the Pringle maneuver is recommended in order to quickly recover portal vein flow during hepatectomy and to improve coagulability.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1007/s00268-020-05570-7 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Management of primary hepatic pregnancy: A case report.
Case Rep Womens Health
December 2024
Department of Internal Medicine, Ethio-Tebib General Hospital, Addis Ababa, Ethiopia.
Hepatic pregnancy, an exceedingly rare subtype of abdominal ectopic pregnancy, remains clinically challenging due to its infrequency, diverse presentations, and diagnostic difficulties. We report the clinical course, diagnostic journey and treatment of a woman with a primary hepatic pregnancy. The patient presented with acute pain in the right hypochondrium and vomiting.
View Article and Find Full Text PDF[Management of internal bleeding : Guidelines of the American Association for the Surgery of Trauma (AAST) and World Society of Emergency Surgery (WSES)].
Radiologie (Heidelb)
January 2025
Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie und Nuklearmedizin, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20251, Hamburg, Deutschland.
Background: Internal bleeding is a common and serious complication in trauma patients. The American Association for the Surgery of Trauma (AAST) and the World Society of Emergency Surgery (WSES) have developed comprehensive guidelines to standardize and optimize the care of these patients. In Germany, abdominal injuries are involved in around 20% of all polytraumas, often caused by falls or road traffic accidents.
View Article and Find Full Text PDFEffects of the Scopist's Skills on the Perioperative Outcomes of Laparoscopic Liver Resection.
Asian J Endosc Surg
November 2024
Department of Surgery, Iwate Medical University School of Medicine, Morioka, Japan.
Article Synopsis
- Laparoscopic liver resection (LLR) is challenging and requires skilled scopists, with this study being the first to evaluate their impact on surgical outcomes during the procedure.
- The study included patients who underwent LLR over five years and categorized scopists into experts (10+ surgeries) and beginners (<10 surgeries) to analyze the effects of their skills on perioperative outcomes.
- Results showed no baseline differences, but beginner scopists caused significantly longer interruptions during surgery due to errors, suggesting that their lack of experience can increase stress for surgeons and extend operation times.
Intraperitoneal and Extraperitoneal Pringle Hepatic Hilar Occlusion in Laparoscopic Liver Resection: A Prospective Randomized Controlled Study.
Curr Med Sci
December 2024
Department of General Surgery, The Second Hospital of Anhui Medical University, Hefei, 230601, China.
Article Synopsis
- The study aimed to assess the safety and effectiveness of using the Pringle maneuver with a bulldog clamp during laparoscopic liver resection.
- 80 patients were randomly assigned to either the intraperitoneal (IPM) or extraperitoneal (EPM) Pringle maneuver groups, measuring various preoperative, intraoperative, and postoperative liver function indices.
- Results showed that IPM had a shorter blocking and operation time, lower inflammatory response, less liver function injury, and quicker recovery compared to EPM, making it a safe and effective technique.
Application of Intraoperative Ultrasound in Laparoscopic Liver Resection with Pringle Maneuver: A Comparative Study with the Pringle Maneuver.
J Laparoendosc Adv Surg Tech A
January 2025
Department of Hepatopancreatobiliary Surgery, Shaoxing People's Hospital, Shaoxing, China.
Appropriate surgical techniques for controlling bleeding and preserving residual liver function are key to the success of laparoscopic liver resection. This study aims to evaluate the application effect of intraoperative ultrasound in the Pringle maneuver of laparoscopic liver resection. Between January 2022 and June 2023, 100 patients underwent laparoscopic liver resection and were randomly allocated to receive application of intraoperative ultrasound for Pringle maneuver (intraoperative ultrasound group, = 50) or conventional Pringle maneuver (conventional group, = 50).
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!