Related Experiment Video
Updated: Jul 4, 2026
Modified Laparoscopic Anatomic Hepatectomy: Two-Surgeon Technique Combined with the Simple Extracorporeal Pringle Maneuver
Published on: June 16, 2023
Hepatectomy using traditional Péan clamp-crushing technique under intermittent Pringle maneuver
Yoichi Ishizaki1, Jiro Yoshimoto, Hiroyuki Sugo
1Department of Hepatobiliary-Pancreatic Surgery, Juntendo University School of Medicine, Tokyo, Japan. ishizaki@med.juntendo.ac.jp
Background:
The clamp-crushing technique has been proved to be the most cost-efficient approach for hepatectomy. If the advantageous characteristics, such as lower blood loss and morbidity, could be utilized, this method could be ideal.
Methods:
The records of 380 patients who underwent hepatectomy using the clamp-crushing technique with intermittent inflow occlusion between 2002 and 2006 were retrospectively reviewed. One hundred fifty patients underwent major hepatectomy, and 230 underwent minor hepatectomy.
Results:
Thirteen (3.4%) patients received red cell transfusion, and 21 (5.5%) patients received fresh frozen plasma. According to Clavien's classification system, grade I complications occurred in 42 (11.1%), grade II in 32 (8.4%), grade III in 14 (3.7%), grade IV in 1 (0.3%), and grade V in 2 (0.5%) patients. Female sex, preoperative albumin-to-globulin ratio, and type of resection were independent factors predictive of blood loss.
Conclusions:
The present patient series, who underwent traditional Péan clamp-crushing technique under intermittent Pringle maneuver, had a low risk of complications. This procedure is an acceptable technique for hepatic parenchymal transection.
