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Intermittent Pringle Versus Continuous Half-Pringle Maneuver for Laparoscopic Liver Resections of Tumors in Segment 7

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Abstract

Segment 7 is considered an unfavorable portion for laparoscopic hepatectomy because of technical difficulties in exposure and controlling bleeding. We compared intermittent Pringle with continuous half-Pringle maneuver in laparoscopic liver resections of tumors in segment 7. A retrospective analysis was conducted in a total of 36 consecutive patients with tumors in segment 7 undergoing laparoscopic liver resections between July 2011 and February 2016 (16 in the Pringle group versus 20 in the half-Pringle group). The two groups were well matched in baseline characteristics. The operative time (274.5 ± 34.3 versus 237.6 ± 41.8 min), overall declamping time (28.4 ± 8.6 versus 2.3 ± 2.5 min), and ischemic duration (69.7 ± 16.5 versus 52.7 ± 13.2 min) were significantly longer in the Pringle group (P < 0.05). The amount of intraoperative blood loss (612.5 ± 222.3 versus 417.4 ± 163.8 mL) and transfusion (335.2 ± 58.7 versus 224.8 ± 76.2 mL) was significantly greater in the Pringle group (P < 0.05). The Pringle group was associated with significantly lower postoperative albumin and higher C-reactive protein levels on postoperative days 1, 3, and 7 (P < 0.05). Laparoscopic hepatectomy for tumors in segment 7 can be performed safely and effectively with successful exposure of surgical field and proper hepatic blood flow occlusion. Continuous half-Pringle maneuver offers the advantages of less operative time and blood loss, less injury, and better recovery.

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Funding

This study was supported by grants from Health Department of Sichuan Province, China, No. 130134 and Doctor Funding of Sichuan Academy of Medical Sciences.

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Authors and Affiliations

  1. The Third Department of Hepatobiliary Surgery, Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, No. 32 West Second Section, First Ring Road, Chengdu, 610072, Sichuan, People’s Republic of China

    Yu Zhang, Xiangyu Lu, Jian Xu, Hongji Yang, Xiaofan Deng, Kai Chen & Yunfei Chen

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  1. Yu Zhang
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  2. Xiangyu Lu
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  3. Jian Xu
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  4. Hongji Yang
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  5. Xiaofan Deng
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  6. Kai Chen
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  7. Yunfei Chen
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Contributions

Yu Zhang and Xiangyu Lu have contributed equally to this work; Yu Zhang, Jian Xu, and Hongji Yang designed the study; Xiangyu Lu, Xiaofan Deng, Chen Kai, and Yunfei Chen collected the patient’s clinical data; Jian Xu analyzed the data and wrote the paper.

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Correspondence to Yu Zhang or Jian Xu.

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Zhang, Y., Lu, X., Xu, J. et al. Intermittent Pringle Versus Continuous Half-Pringle Maneuver for Laparoscopic Liver Resections of Tumors in Segment 7. Indian J Surg 80, 146–153 (2018). https://doi.org/10.1007/s12262-018-1721-8

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  • DOI: https://doi.org/10.1007/s12262-018-1721-8

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