Related Experiment Video
Updated: Aug 29, 2026
A Reproducible Intensive Care Unit-Oriented Endotoxin Model in Rats
Published on: February 20, 2021
Bacterial translocation, endotoxaemia and apoptosis following Pringle manoeuvre in rats
Kriton S Filos1, Ioannis Kirkilesis, Iris Spiliopoulou
1Department of Anaesthesiology and Critical Care Medicine, School of Medicine, University of Patras, Patras, Greece.
Background:
Intraoperative occlusion of the hepatoduodenal ligament (Pringle manoeuvre (Pm)) is often employed for the reduction of blood loss during liver surgery. No data exist to date on the effects of Pm on mucosal barrier dysfunction, systemic bacterial translocation (BT), endotoxaemia and apoptosis.
Materials And Methods:
Sixty-five male Wistar rats in three groups: I (n=25) controls, II (n=20) sham operation, III (n=20) occlusion of the hepatoduodenal ligament (Pm). Tissue samples from mesenteric lymph nodes (MLNs), liver, lungs and spleen were analysed after 30 min and at 24 h. Endotoxin was measured in portal and aortic blood and routine haematological and biochemical parameters were measured before and after Pm.
Results:
No differences were found in the blood parameters before and after Pm, but a significant increase in contaminated MLNs and liver was noted. All cultured bacteria were enteric in origin. Portal and aortic endotoxin were significantly increased. Overall the ileal architecture remained intact in all specimens studied and no significant pathology was observed. The ABC increased after Pm significantly (P<0.01).
Conclusion:
Normothermic Pm of 30 min duration results in immediate and delayed gut barrier failure by significantly increasing BT and endotoxaemia which might be attributed to portal stasis leading to intestinal congestion as well as temporary liver ischaemia. Apoptosis increased significantly 30 min after performing the Pm.
Insights
The Pringle maneuver (Pm) used in liver surgery increases bacterial translocation and endotoxemia, indicating gut barrier failure. This occurs due to portal stasis and liver ischemia, affecting gut barrier function and increasing apoptosis.
Area of Science:
- Hepatobiliary Surgery
- Gastrointestinal Physiology
- Surgical Complications
Background:
- The Pringle maneuver (Pm) is used to reduce blood loss during liver surgery.
- Effects of Pm on gut barrier, bacterial translocation (BT), endotoxemia, and apoptosis are unknown.
Purpose of the Study:
- To investigate the impact of normothermic Pringle maneuver (Pm) on gut barrier function, bacterial translocation (BT), endotoxemia, and apoptosis in a rat model.
Main Methods:
- Wistar rats underwent sham operation or Pm (30 min occlusion).
- Mesenteric lymph nodes, liver, lungs, and spleen were analyzed for bacterial contamination.
- Portal and aortic endotoxin levels were measured.
- Apoptosis was assessed post-Pm.
Main Results:
- Pm significantly increased bacterial contamination in mesenteric lymph nodes and liver.
- Portal and aortic endotoxin levels significantly increased post-Pm.
- Apoptosis was significantly elevated 30 minutes after Pm.
Conclusions:
- A 30-minute normothermic Pringle maneuver causes gut barrier failure.
- Increased bacterial translocation and endotoxemia suggest compromised gut integrity.
- Portal stasis and liver ischemia likely contribute to these detrimental effects.
