Half-Pringle maneuver: a useful tool in laparoscopic liver resection

Area of Science:

• Minimally Invasive Surgery
• Hepatobiliary Surgery
• Surgical Oncology

Background:

• Laparoscopic liver resections are increasingly common, with bleeding during parenchymal transection being a primary concern.
• Total vascular inflow occlusion risks ischemic reperfusion injuries, increasing postoperative morbidity.
• Hemihepatic inflow occlusion (half-Pringle maneuver) limits ischemia to one liver side, reducing reperfusion damage and blood loss.

Purpose of the Study:

• To evaluate the feasibility and safety of the half-Pringle maneuver in laparoscopic liver resections.
• To describe the surgical experience with this technique for segmental and nonanatomic liver resections.

Main Methods:

• A retrospective review of eight patients undergoing laparoscopic liver resection at a single tertiary center.
• The half-Pringle maneuver was employed for vascular inflow occlusion during the procedures.

Main Results:

• The study included 8 patients (5 women, 3 men) with a mean age of 40.2 years.
• Mean tumor size was 4.1 cm, and mean hospital stay was 3.1 days.
• Resected pathologies included liver adenomas, hepatocellular carcinomas, and various metastatic liver cancers. No postoperative complications or mortalities occurred.

Conclusions:

• Laparoscopic liver resection utilizing the half-Pringle maneuver is a safe and feasible technique.
• This method can be incorporated into the surgical repertoire for selected laparoscopic liver resection cases.
• The half-Pringle maneuver offers advantages in managing bleeding and minimizing ischemic injury during liver surgery.