Pringle Maneuver in Extended Liver Resection: A propensity score analysis.
Journal
Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288
Informations de publication
Date de publication:
01 06 2020
01 06 2020
Historique:
received:
31
10
2019
accepted:
12
04
2020
entrez:
3
6
2020
pubmed:
3
6
2020
medline:
27
11
2020
Statut:
epublish
Résumé
Despite the ongoing decades-long controversy, Pringle maneuver (PM) is still frequently used by hepatobiliary surgeons during hepatectomy. The aim of this study was to investigate the effect of PM on intraoperative blood loss, morbidity, and posthepatectomy hemorrhage (PHH). A series of 209 consecutive patients underwent extended hepatectomy (EH) (≥5 segment resection). The association of PM with perioperative outcomes was evaluated using multivariate analysis with a propensity score method to control for confounding. Fifty patients underwent PM with a median duration of 19 minutes. Multivariate analysis revealed that risk of excessive intraoperative bleeding (≥1500 ml; odds ratio [OR] 0.27, 95%-confidence interval [CI] 0.10-0.70, p = 0.007), major morbidity (OR 0.41, 95%-CI 0.18-0.97, p = 0.041), and PHH (OR 0.22, 95%-CI 0.06-0.79, p = 0.021) were significantly lower in PM group after EH. Furthermore, there was no significant difference in 3-year recurrence-free-survival between groups. PM is associated with lower intraoperative bleeding, PHH, and major morbidity risk after EH. Performing PM does not increase posthepatectomy liver failure and does not affect recurrence rate. Therefore, PM seems to be justified in EH.
Identifiants
pubmed: 32483357
doi: 10.1038/s41598-020-64596-y
pii: 10.1038/s41598-020-64596-y
pmc: PMC7264345
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
8847Références
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