Modified technique of Pringle's maneuver in resection of the liver.
Crushing of the hepatic parenchyma with hepatic clamps to minimize blood loss during resection of the liver leads to mechanical damage of hepatocytes. Pringle's maneuver may precipitate liver failure by hepatic warm ischemia as well. Therefore, we controlled bleeding from the surface of the resection by using light compression on the hepatic parenchyma with a band while applying a hepatic arterial clamp at the hepatic hilus. This vascular control method can be done because the portal pressure is about one-tenth of the hepatic artery pressure and provides an efficient and harmless transection of the liver.
Matsumata
T
T
Second Department of Surgery, Kyushu University, Fukuoka, Japan.
Kanematsu
T
T
Shirabe
K
K
Yamagata
M
M
Utsunomiya
T
T
Furuta
T
T
Sugimachi
K
K
D000818:Animals; D006528:Carcinoma, Hepatocellular / Q000601:surgery*; D003250:Constriction; D004285:Dogs; D006470:Hemorrhage / Q000517:prevention & control; D006488:Hemostasis, Surgical; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008103:Liver Cirrhosis / Q000601:surgery*; D008113:Liver Neoplasms / Q000601:surgery*; D011183:Postoperative Complications / Q000517:prevention & control; D011312:Pressure