Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Experiment Video

Updated: Jun 5, 2026

Modified Laparoscopic Anatomic Hepatectomy: Two-Surgeon Technique Combined with the Simple Extracorporeal Pringle Maneuver
12:27

Modified Laparoscopic Anatomic Hepatectomy: Two-Surgeon Technique Combined with the Simple Extracorporeal Pringle Maneuver

Published on: June 16, 2023

Current protective strategies in liver surgery.

Kurinchi S Gurusamy1, Hector D Gonzalez, Brian R Davidson

  • 1HPB and Liver Transplantation, Royal Free Campus, University College London Medical School, Royal Free Hospital, 9th Floor, Pond Street, London, NW3 2QG, United Kingdom. kurinchi2k@hotmail.com

World Journal of Gastroenterology
|December 25, 2010
PubMed
Summary

Liver injury from reduced blood flow (ischemia-reperfusion) is common in liver surgery. While several strategies show promise in animal models, none are clinically recommended due to insufficient evidence from human trials.

Related Concept Videos

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

Reasoning in machine vision by learning fast and slow thinking.

Nature communications·2026
Same author

Warm-started reinforcement learning for iterative 3D/2D liver registration.

International journal of computer assisted radiology and surgery·2026
Same author

Real Time Evaluation of Whole Organ Perfusion by Magnetic Resonance Imaging in Ex Vivo Machine-Perfused Liver.

NMR in biomedicine·2026
Same author

Anticoagulation Practice and Risk of Portal Vein Thrombosis Following Pancreaticoduodenectomy or Total Pancreatectomy with Venous Resection: An International Multicentre Cohort Study.

Annals of surgery·2025
Same author

Correction: Deep hashing for global registration of preoperative CT and video images for laparoscopic liver surgery.

International journal of computer assisted radiology and surgery·2025
Same author

Tube2FEM: a general-purpose highly automated pipeline for flow-related processes in (embedded) tubular objects.

Royal Society open science·2025

Area of Science:

  • Hepatology
  • Surgical Research
  • Transplantation Medicine

Background:

  • Liver surgery, including resection and transplantation, involves periods of ischemia (reduced blood flow) followed by reperfusion, leading to significant liver injury.
  • Ischemia-reperfusion (IR) injury is a critical complication affecting patient outcomes and graft survival.
  • Current management strategies focus on mitigating this injury through various protective measures.

Purpose of the Study:

  • To review and evaluate the clinical efficacy of different strategies aimed at modulating ischemia-reperfusion (IR) injury in the context of liver surgery.
  • To assess the current evidence supporting interventions like hypothermia, ischemic preconditioning (IPC), postconditioning, pharmacological agents, gene therapy, and machine perfusion.
  • To identify the gaps in clinical research and the need for further randomized controlled trials.

Related Experiment Videos

Last Updated: Jun 5, 2026

Modified Laparoscopic Anatomic Hepatectomy: Two-Surgeon Technique Combined with the Simple Extracorporeal Pringle Maneuver
12:27

Modified Laparoscopic Anatomic Hepatectomy: Two-Surgeon Technique Combined with the Simple Extracorporeal Pringle Maneuver

Published on: June 16, 2023

Main Methods:

  • Review of existing literature on interventions for IR injury in liver surgery.
  • Analysis of data from randomized controlled trials (RCTs) and systematic reviews.
  • Evaluation of experimental data from animal models versus clinical evidence.

Main Results:

  • Hypothermia and static cold storage with University of Wisconsin solution are established methods that reduce IR injury and improve graft function.
  • Experimental studies suggest potential benefits from IPC, ischemic postconditioning, pharmacological agents, gene therapy, and machine perfusion.
  • However, a lack of robust RCTs for postconditioning, gene therapy, and machine perfusion limits clinical recommendations.
  • While IPC and pharmacological agents have shown biochemical or histological improvements in RCTs, these have not translated to significant clinical benefit.

Conclusions:

  • Despite promising preclinical data, most novel strategies to mitigate liver ischemia-reperfusion injury lack sufficient clinical validation.
  • Further well-designed randomized controlled trials are essential to establish the safety and efficacy of emerging protective strategies before widespread clinical adoption in liver resection.
  • Current clinical practice relies on established methods like hypothermia and specific preservation solutions, with ongoing research needed for newer interventions.