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Complete Hemihepatic Vascular Exclusion versus Pringle Maneuver for Liver Resection: a Comparative Study.
MedLine Citation:
PMID:  21937400     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Background/Aims: This non-randomized study aimed to compare the perioperative outcomes of complete hemihepatic vascular exclusion (CHVE) vs. Pringle maneuver in partial hepatectomy. Methodology: From February 2006 to September 2008, 129 consecutive patients with resectable tumors confined to a hemi-liver underwent hepatic resection with CHVE (n=55) or Pringle maneuver (n=74). The surgical outcomes were compared. Results: The vascular clamp time in the CHVE group was significantly longer than the Pringle group (mean, 35.3min vs. 25.3min). The operating time and the liver transection time in the CHVE group were significantly longer. Blood loss and blood loss per transection surface area was significantly lower in the CHVE group than the Pringle group. The CHVE group had significantly fewer patients who required blood transfusion (n=8 vs. n=23). Both groups had similar complication rates (18.2% vs. 23%). There was no procedure-related mortality. The serum pre-albumin levels on days 3 and 7 after operation in the CHVE group were significantly higher than the Pringle group. The serum ALT levels on days 1, 3 and 7 after operation in the CHVE group were significantly lower than the Pringle group. There were no significant differences in the postoperative serum total bilirubin levels between the two groups. Conclusions: CHVE is safe and feasible in selected patients. Using CHVE during liver transection resulted in less blood loss and less hepatic ischemia-reperfusion injury in the early postoperative period than using Pringle maneuver.
Authors:
Ying Tong; Jia-Mei Yang; Eric C H Lai; Wan Yee Lau; Meng-Chao Wu
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Hepato-gastroenterology     Volume:  58     ISSN:  0172-6390     ISO Abbreviation:  Hepatogastroenterology     Publication Date:    2011 Jul-Aug
Date Detail:
Created Date:  2011-09-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8007849     Medline TA:  Hepatogastroenterology     Country:  Greece    
Other Details:
Languages:  eng     Pagination:  1307-11     Citation Subset:  IM    
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