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Pringle Maneuver in Extended Liver Resection: A propensity score analysis
Mohammed Al-Saeedi1, Omid Ghamarnejad1, Elias Khajeh1
1Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany.
Scientific Reports
|June 3, 2020
Summary
The Pringle maneuver (PM) reduces bleeding, major morbidity, and posthepatectomy hemorrhage during extended hepatectomy (EH). This hepatobiliary surgery technique does not impact recurrence rates, suggesting it is justified.
Area of Science:
- Hepatobiliary Surgery
- Surgical Oncology
- Gastroenterology
Background:
- The Pringle maneuver (PM) is a controversial technique used in hepatectomy.
- Its impact on perioperative outcomes remains debated among hepatobiliary surgeons.
Purpose of the Study:
- To evaluate the effect of the Pringle maneuver (PM) on intraoperative blood loss.
- To assess the influence of PM on morbidity and posthepatectomy hemorrhage (PHH) after extended hepatectomy (EH).
Main Methods:
- A retrospective analysis of 209 patients undergoing extended hepatectomy (EH).
- Multivariate analysis and propensity score matching were employed to control for confounding factors.
- Outcomes compared between patients who did and did not undergo the Pringle maneuver (PM).
Main Results:
- Patients undergoing PM had significantly lower excessive intraoperative bleeding (≥1500 ml).
- The risk of major morbidity and posthepatectomy hemorrhage (PHH) was significantly reduced in the PM group.
- No significant difference in 3-year recurrence-free survival was observed between the groups.
Conclusions:
- The Pringle maneuver (PM) is associated with reduced intraoperative bleeding, PHH, and major morbidity following extended hepatectomy (EH).
- Performing PM does not increase the risk of posthepatectomy liver failure or affect recurrence rates.
- The Pringle maneuver (PM) appears to be a justified and beneficial technique in extended hepatectomy (EH).
