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Related Experiment Video

Updated: Jun 26, 2026

Modified Laparoscopic Anatomic Hepatectomy: Two-Surgeon Technique Combined with the Simple Extracorporeal Pringle Maneuver
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Vascular occlusion for elective liver resections.

Kurinchi Selvan Gurusamy1, Yogesh Kumar, Rajarajan Ramamoorthy

  • 1University Department of Surgery, Royal Free Hospital and University College School of Medicine, 9th Floor, Royal Free Hospital, Pond Street, London, UK, NW3 2QG. kurinchi2k@hotmail.com

The Cochrane Database of Systematic Reviews
|January 23, 2009
PubMed
Summary
This summary is machine-generated.

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Vascular occlusion during liver resection reduces blood loss but may elevate liver enzymes. While seemingly safe, intermittent vascular occlusion does not appear to decrease peri-operative morbidity, necessitating further research.

Area of Science:

  • Hepatobiliary surgery
  • Surgical oncology
  • Clinical trials

Background:

  • Vascular occlusion is a technique employed during liver resection to mitigate blood loss.
  • There is ongoing debate regarding the benefits and risks of employing vascular occlusion in elective liver resections.

Purpose of the Study:

  • To evaluate the advantages, such as reduced blood loss and peri-operative morbidity, of vascular occlusion.
  • To assess the disadvantages, including ischemia-reperfusion injury and subsequent liver dysfunction, associated with vascular occlusion.

Main Methods:

  • A systematic review of randomized clinical trials was conducted, searching databases including Cochrane Hepato-Biliary Group Controlled Trials Register, CENTRAL, MEDLINE, EMBASE, and Science Citation Index Expanded up to August 2008.
  • Five trials comparing vascular occlusion with no vascular occlusion during elective liver resections were included.

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  • Data were independently extracted and analyzed using fixed-effect and random-effects models, calculating risk ratios and mean differences with 95% confidence intervals.

    • Main Results:

    • A total of five trials (high bias-risk) involving 166 patients with vascular occlusion and 165 without were analyzed.
    • Vascular occlusion was associated with significantly lower blood loss compared to no occlusion.
    • No significant differences were observed in mortality, liver failure, or other morbidities; however, liver enzymes were significantly elevated in the vascular occlusion group.

    Conclusions:

    • Intermittent vascular occlusion appears to be a safe practice during liver resection.
    • Current evidence suggests that intermittent vascular occlusion does not significantly decrease peri-operative morbidity.
    • Further randomized trials are required to definitively establish the role and impact of vascular occlusion in liver resections.