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Related Experiment Videos

Pringle's maneuver lasting 322 min.

Y Sakamoto1, M Makuuchi, T Takayama

  • 1Second Department of Surgery, Faculty of Medicine, University of Tokyo, Japan.

Hepato-Gastroenterology
|May 6, 1999
PubMed
Summary
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This study demonstrates that intermittent Pringle

Area of Science:

  • Hepatobiliary Surgery
  • Surgical Oncology
  • Liver Metastasis Management

Background:

  • The Pringle maneuver is crucial for controlling intraoperative bleeding during hepatectomy.
  • Continuous Pringle maneuver has a documented safe limit of 127 minutes of hepatic ischemia.
  • Extending safe ischemia time is critical for complex liver resections, especially for extensive metastases.

Observation:

  • A 49-year-old male patient with 18 liver metastases from leiomyosarcoma underwent surgical resection.
  • Intermittent Pringle maneuver was employed to facilitate complete tumor enucleation.
  • The liver experienced a cumulative ischemic time of 322 minutes.

Findings:

  • Despite the extended 322-minute cumulative hepatic ischemia, the patient maintained normal postoperative serum total bilirubin levels.

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  • The patient was discharged on postoperative day 24 without complications.
  • The patient remained well for 5 months post-surgery, indicating successful tumor removal and liver preservation.

    • Implications:

    • Intermittent Pringle maneuver significantly extends the safe upper limit of hepatic ischemia beyond previously reported durations.
    • This technique offers a viable strategy for managing extensive liver metastases, improving patient outcomes.
    • The findings suggest a potential paradigm shift in managing complex hepatectomy cases requiring prolonged ischemia.