Abstract
BackgroundThough accumulated evidence proved the advantages of laparoscopic hepatectomy, bleeding still remains the most important challenge in clinical practice. Our study aimed to compare the outcomes of Pringle maneuver (PM) and selective hemihepatic vascular occlusion (SHVO) surgeries for patients with liver cavernous hemangioma (LCH).MethodsThe SHVO (n = 26; mean age, 42) and PM (n = 78; mean age, 43) surgeries were performed in 104 LCH patients from January 2006 to January 2015. The intraoperative (bleeding, arterial pressure, oxyhemoglobin saturation, etc.) and postoperative parameters (anal exhaust time, complications, blood cell numbers, etc.) were measured and compared between the two groups. Liver function of all these patients was detected by blood test at 1-day preoperation, and at 1, 3, and 5 days postoperation.ResultsBoth of the two surgeries were successfully performed without any mortality. The intraoperative systolic arterial pressure and pulse in PM group were much higher than that in SHVO group (P < 0.01). The postoperative liver function parameters such as alanine transaminase (ALT), aspartate transaminase (AST), and total bilirubin (TBIL) increased much more in the PM group than that in the SHVO group compared with preoperation results (P < 0.05). However, there were no statistical differences in intraoperative bleeding, blood transfusion, hepatic inflow occlusion time, oxygen saturation occlusion, anal exhaust time and incidence of complications between the two groups (P > 0.05).ConclusionsSHVO is safer with less ischemia reperfusion injury than PM surgery for hemangioma resection on patients with LCH.
Highlights
Though accumulated evidence proved the advantages of laparoscopic hepatectomy, bleeding still remains the most important challenge in clinical practice
alanine transaminase (ALT), aspartate transaminase (AST), and total bilirubin (TBIL) increased much more in the Pringle maneuver (PM) group than that in the selective hemihepatic vascular occlusion (SHVO) group compared with preoperation results (P < 0.05)
The results showed that the intraoperative systolic arterial pressure and pulse in the PM group were much higher than that in the SHVO group, indicating that the effect of hemodynamics caused by SHVO surgery was much less than that caused by PM
Summary
Though accumulated evidence proved the advantages of laparoscopic hepatectomy, bleeding still remains the most important challenge in clinical practice. Our study aimed to compare the outcomes of Pringle maneuver (PM) and selective hemihepatic vascular occlusion (SHVO) surgeries for patients with liver cavernous hemangioma (LCH). Pringle maneuver (PM) and selective hemihepatic vascular occlusion (SHVO) methods are two common. Though the validity of PM is reported to reduce hemorrhage in liver resection, it usually induces ischemia reperfusion injury in many cases [9, 10]. In order to avoid the ischemia reperfusion injury, the SHVO technique which can allow normal blood supply at contralateral hemi-liver is proposed [11]. This technique will induce more bleeding from the other hemi-liver and will cause serious complications
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
