Intermittent Pringle Versus Continuous Half-Pringle Maneuver for Laparoscopic Liver Resections of Tumors in Segment 7 |
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Authors: | Yu Zhang Xiangyu Lu Jian Xu Hongji Yang Xiaofan Deng Kai Chen Yunfei Chen |
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Affiliation: | 1.The Third Department of Hepatobiliary Surgery, Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital, School of Medicine,University of Electronic Science and Technology of China,Chengdu,People’s Republic of China |
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Abstract: | Segment 7 is considered an unfavorable portion for laparoscopic hepatectomy because of technical difficulties in exposure and controlling bleeding. We compared intermittent Pringle with continuous half-Pringle maneuver in laparoscopic liver resections of tumors in segment 7. A retrospective analysis was conducted in a total of 36 consecutive patients with tumors in segment 7 undergoing laparoscopic liver resections between July 2011 and February 2016 (16 in the Pringle group versus 20 in the half-Pringle group). The two groups were well matched in baseline characteristics. The operative time (274.5?±?34.3 versus 237.6?±?41.8 min), overall declamping time (28.4?±?8.6 versus 2.3?±?2.5 min), and ischemic duration (69.7?±?16.5 versus 52.7?±?13.2 min) were significantly longer in the Pringle group (P?0.05). The amount of intraoperative blood loss (612.5?±?222.3 versus 417.4?±?163.8 mL) and transfusion (335.2?±?58.7 versus 224.8?±?76.2 mL) was significantly greater in the Pringle group (P?0.05). The Pringle group was associated with significantly lower postoperative albumin and higher C-reactive protein levels on postoperative days 1, 3, and 7 (P?0.05). Laparoscopic hepatectomy for tumors in segment 7 can be performed safely and effectively with successful exposure of surgical field and proper hepatic blood flow occlusion. Continuous half-Pringle maneuver offers the advantages of less operative time and blood loss, less injury, and better recovery. |
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