Laparoscopic Hepatic Resection Using Extracorporeal Pringle Maneuver

Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a
Yoshihiro InoueKazuhisa Uchiyama

Abstract

Laparoscopic hepatic resection (LHR) has been developed as a novel minimally invasive surgery. However, despite improvements in equipment and procedures, intraoperative hemorrhage remains an issue that requires great precaution. To reduce the amount of intraoperative blood loss, we perform the Pringle maneuver, aimed at occluding the inflow of blood into the liver during LHR. This article describes our experience performing LHR using the Pringle maneuver, including postoperative results, and discusses the safety and effectiveness of the Pringle maneuver. Data from 83 patients who underwent laparoscopic partial right hepatic resection with or without the Pringle maneuver were retrospectively analyzed with respect to surgical outcomes, safety, and utility. In LHR, the amount of bleeding was significantly lower in cases that included the Pringle maneuver (P = .0314). However, there were no differences in the duration of surgery, surgical margin, rate of curative resections, and incidence of postoperative complications. Laboratory data collected after surgery showed no significant difference between the two groups regardless of whether blood flow was occluded or not. The Pringle maneuver may be effective in reducing the amount of i...Continue Reading

References

Oct 1, 1908·Annals of Surgery·J H Pringle
Jun 26, 2008·Gastrointestinal Endoscopy·H Juergen Nord
Jul 30, 2009·Annals of Surgery·Pierre A ClavienMasatoshi Makuuchi
Sep 1, 2009·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Mickael LesurtelPierre-Alain Clavien
Mar 1, 2012·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Yoshihiro InoueKazuhisa Uchiyama
Sep 13, 2012·Annals of Surgery·Takeaki IshizawaBrice Gayet
Aug 9, 2016·Hepatobiliary Surgery and Nutrition·Tullio PiardiDaniele Sommacale
Feb 10, 2017·Digestive Surgery·Yoshihiro InoueKazuhisa Uchiyama

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