Intermittent Pringle maneuver is unlikely to induce bacterial translocation to the portal vein: a study using bacterium‐specific ribosomal RNA‐targeted reverse transcription‐polymerase chain reaction

Yamaguchi, Naoya; Yokoyama, Yukihiro; Igami, Tsuyoshi; Sugawara, Gen; Asahara, Takashi; Nomoto, Koji; Nagino, Masato

doi:10.1002/jhbp.239

Cited by 5 publications

(3 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In van Wagensveld et al ( 16 ) study, INT ischemia was induced by clamping hepatic pedicle in eight successive periods of 12 minutes ischemia and 3 minutes of reperfusion. Intermittent hepatic vascular inflow occlusion during prolonged liver ischemia (120 minutes) in pigs resulted in less microcirculatory and hepatocellular injury, compared to continuous occlusion ( 17 , 18 ).…”

Section: Discussionmentioning

confidence: 93%

Evaluation of the Safe Ischemic Time of Clamping During Intermittent Pringles Maneuver in Rabbits

et al. 2015

View full text Add to dashboard Cite

Background:The liver is the most commonly injured organ in blunt abdominal trauma. Although major hepatic bleeding may be partially controlled with portal triade clamping (the Pringle’s maneuver), continuous prolonged clamping results in liver ischemia.Objectives:The purpose of this study was to determine the safe time of Pringle maneuver based on pathologic changes of liver in rabbit models.Materials and Methods:In an experimental study, 20 New-Zealand white rabbits were selected. In laparotomy, a blunt dissector was passed through the foramen of Winslow and the hepato-duodenal ligament encircled with an umbilical tape. En masse Pringle maneuver was performed using atraumatic flexible clamps. Rabbits were divided into four groups based on Pringle maneuver time (30 minutes, 45 minutes, 60 minutes, and 75 minutes). A hepatic biopsy was performed at the beginning of operation. The degree of tissue injury was evaluated using blood markers.Results:There were five rabbits in each group. At the end of 60 minutes ischemia, only minor alterations were observed in pathological specimens. At the end of 75 minutes, hepatocyte damage and necrosis were observed. The serum levels of alanine aminotransferase (Group A: P = 0.02; Group B: P = 0.01; Group C: P = 0.0002; Group D: P = 0.01) and Aspartate aminotransferase (Group A: P = 0.03; Group B: P = 0.002; Group C: P = 0.0004; Group D: P = 0.0003) were significantly increased post-operatively. The maximum level was in the first day after operation.Conclusions:Continuous portal triade clamping (the Pringle maneuver) during liver ischemia (30 and 45 minutes) in rabbits resulted in no ischemic change. Increasing time of clamping to 30 minutes was safe in intermittent Pringle maneuver.

show abstract

Section: Discussionmentioning

confidence: 93%

Evaluation of the Safe Ischemic Time of Clamping During Intermittent Pringles Maneuver in Rabbits

et al. 2015

View full text Add to dashboard Cite

show abstract

“…Massive intraoperative blood loss may lead to a longer time of systemic hypoperfusion and affects oxygen delivery to vital organs [ 2 ]. In addition, perioperative blood transfusion due to massive blood loss is associated with worse survival outcomes in postoperative patients [ 3 , 4 ]. Therefore, techniques which can help minimize bleeding during the hepatic resection are demanded to be developed.…”

Section: Introductionmentioning

confidence: 99%

Safety and effectiveness evaluation of a two-handed technique combining harmonic scalpel and laparoscopic Peng’s multifunction operative dissector in laparoscopic hemihepatectomy

et al. 2021

View full text Add to dashboard Cite

Objectives This study was designed to evaluate the safety and effectiveness of a two-hand technique combining harmonic scalpel (HS) and laparoscopic Peng’s multifunction operative dissector (LPMOD) in patients who underwent laparoscopic hemihepatectomy (LHH). Methods We designed and conducted a case-control study nested in a prospectively collected laparoscopic liver surgery database. Patients who underwent LHH for liver parenchyma transection using HS + LPMOD were defined as cases (n = 98) and LPMOD only as controls (n = 47) from January 2016 to May 2018. Propensity score matching (1:1) between the case and control groups was used in the analyses. Results The case group had significantly less intraoperative blood loss in milliliters (169.4 ± 133.5 vs. 221.5 ± 176.3, P = 0.03) and shorter operative time in minutes (210.5 ± 56.1 vs. 265.7 ± 67.1, P = 0.02) comparing to the control group. The conversion to laparotomy, postoperative hospital stay, resection margin, the mean peak level of postoperative liver function parameters, bile leakage rate, and others were comparable between the two groups. There was no perioperative mortality. Conclusions We demonstrated that the two-handed technique combing HS and LPMOD in LHH is safe and effective which is associated with shorter operative time and less intraoperative blood loss compared with LPMOD alone. The technique facilitates laparoscopic liver resection and is recommended for use.

show abstract

“…Massive intraoperative blood loss may lead to longer time of systemic hypoperfusion and affects oxygen delivery to vital organs [2]. In addition, perioperative blood transfusion due to massive blood loss is associated with worse survival outcomes in postoperative patients [3,4]. Therefore, techniques which can help minimize bleeding during the hepatic resection are demanded to be developed.…”

Section: Introductionmentioning

confidence: 99%

Safety and Effectiveness Evaluation of A Two-Handed Technique Combining Harmonic Scalpel and Laparoscopic Peng’s Multifunction Operative Dissector in Laparoscopic Hemihepatectomy

Cai

Jiang

Liang

et al. 2021

Preprint

View full text Add to dashboard Cite

ObjectivesThis study was designed to evaluate the safety and effectiveness of a two-hand technique combining harmonic scalpel (HS) and laparoscopic Peng’s multifunction operative dissector (LPMOD) in patients who underwent laparoscopic hemihepatectomy (LHH).MethodsWe designed and conducted a case-control study nested in a prospectively collected laparoscopic liver surgery database. Patients who underwent LHH for liver parenchyma transection using HS + LPMOD were defined as cases (n = 98) and LPMOD only as controls (n = 47) from January, 2016 to May, 2018. Propensity score matching (1:1) between the case and control groups was used in the analyses. ResultsThe case group had significantly less intraoperative blood loss in mL (169.4 ± 133.5 vs. 221.5 ± 176.3, P = 0.03) and shorter operative time in minutes (210.5 ± 56.1 vs. 265.7 ± 67.1, P = 0.02) comparing to the control group. The conversion to laparotomy, postoperative hospital stay, resection margin, the mean peak level of postoperative liver function parameters, bile leakage rate and others were comparable between the two groups. There was no perioperative mortality. ConclusionsWe demonstrated that the two-handed technique combing HS and LPMOD in LHH is safe and effective which is associated with shorter operative time and less intraoperative blood loss compared with LPMOD alone. The technique facilitates laparoscopic liver resection and is recommended for use.

show abstract

Intermittent Pringle maneuver is unlikely to induce bacterial translocation to the portal vein: a study using bacterium‐specific ribosomal RNA‐targeted reverse transcription‐polymerase chain reaction

Abstract: The intermittent Pringle maneuver is unlikely to induce BT to the portal circulation and is safe, even in difficult, complicated hepatobiliary resections requiring long clamping times.

Cited by 5 publications

References 32 publications

Evaluation of the Safe Ischemic Time of Clamping During Intermittent Pringles Maneuver in Rabbits

Evaluation of the Safe Ischemic Time of Clamping During Intermittent Pringles Maneuver in Rabbits

Safety and effectiveness evaluation of a two-handed technique combining harmonic scalpel and laparoscopic Peng’s multifunction operative dissector in laparoscopic hemihepatectomy

Safety and Effectiveness Evaluation of A Two-Handed Technique Combining Harmonic Scalpel and Laparoscopic Peng’s Multifunction Operative Dissector in Laparoscopic Hemihepatectomy

Contact Info

Product

Resources

About