Effects of intermittent Pringle's manoeuvre on cirrhotic compared with normal liver

The British Journal of Surgery
Y SugiyamaS Kawasaki

Abstract

Although patients with liver cirrhosis are supposed to tolerate ischaemia-reperfusion poorly, the exact impact of intermittent inflow clamping during hepatic resection of cirrhotic compared with normal liver remains unclear. Intermittent Pringle's manoeuvre was applied during minor hepatectomy in 172 patients with a normal liver, 59 with chronic hepatitis and 97 with liver cirrhosis. To assess hepatic injury, delta (D)-aspartate aminotransferase (AST) and D-alanine aminotransferase (ALT) (maximum level minus preoperative level) were calculated. To evaluate postoperative liver function, postoperative levels of total bilirubin, albumin and cholinesterase (ChE), and prothrombin time were measured. Significant correlations between D-AST or D-ALT and clamping time were found in each group. The regression coefficients of the regression lines for D-AST and D-ALT in patients with normal liver were significantly higher than those in patients with cirrhotic liver. Irrespective of whether clamping time was 45 min or less, or at least 60 min, D-AST and D-ALT were significantly lower in patients with cirrhosis than in those with a normal liver. Parameters of hepatic functional reserve, such as total bilirubin, prothrombin time, albumin and ...Continue Reading

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Citations

Apr 27, 2011·Amino Acids·Mendel Friedman, Carol E Levin
May 30, 2013·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Jun-sheng NiWei-ping Zhou
Dec 3, 2014·Surgical Oncology Clinics of North America·Christoph W Michalski, Kevin G Billingsley
Jan 7, 2014·BioMed Research International·Serdar TopalogluMithat Kerim Arslan
Oct 7, 2011·World Journal of Surgery·Takehiro OkabayashiKazuhiro Hanazaki
Aug 28, 2014·Surgical Endoscopy·Monica M DuaBrendan C Visser
Sep 17, 2014·Annals of Surgical Oncology·Takeo NomiBrice Gayet
Apr 2, 2014·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Sangbin HanJaewon Joh
Feb 19, 2015·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Sangbin HanJae-Won Joh
Mar 1, 2018·Brazilian Journal of Medical and Biological Research = Revista Brasileira De Pesquisas Médicas E Biológicas·Fang XieYu-Kun Luo
Jan 30, 2013·Liver International : Official Journal of the International Association for the Study of the Liver·Maartje A J van den BroekSteven W M Olde Damink
Sep 19, 2015·World Journal of Hepatology·Danijel GalunMiroslav Milicevic
Jul 29, 2015·World Journal of Gastroenterology : WJG·Roberto MontaltiRoberto Ivan Troisi
Aug 10, 2011·Journal of Perioperative Practice·Chris JonesNial Quiney
Sep 30, 2020·Surgical Endoscopy·Ioannis A ZiogasDavid A Geller

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