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| Outcomes of Pringle maneuver in patients undergoing hepatic resection for colorectal liver metastases |
| Li Lian Kuan a , b , ∗, Christopher P Neal a , Vaux Robertson a , Michael Jones a , Ashley R Dennison a , Giuseppe Garcea a |
a Department of Hepatobiliary and Pancreatic Surgery, Leicester General Hospital, University Hospitals of Leicester NHS Trust, Gwendolen Road, Leicester LE5 4PW, UK
b Discipline of Surgery, The Queen Elizabeth Hospital, The University of Adelaide, Adelaide, South Australia, Australia
∗ Corresponding author at: Department of Hepatobiliary and Pancreatic Surgery, Leicester General Hospital, University Hospitals of Leicester NHS Trust, Gwendolen Road, Leicester LE5 4PW, UK.
E-mail address: kuan.lilian@gmail.com (L.L. Kuan). |
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Abstract The Pringle maneuver (PM) was initially described more than a century ago to control bleeding associated with hepatic trauma and it remains the most common method to block hepatic inflow and minimize blood loss during hepatic resections [1]. The potential effects of ischemia-reperfusion injury (IRI), a consequence of the PM, on the function of the liver remnant remain controversial [2]. Pre-clinical data have suggested that IRI may potentiate the growth of metastatic colorectal cells [3] , raising concerns regarding long-term oncological outcomes associated with use of the PM. Several large clinical studies involving patients undergoing resections for colorectal liver metastases (CRLM) have shown no significant differences in survival or hepatic recurrence regardless of whether the PM is used [4,5]. However, there remain concerns whether the PM may influence long-term oncological outcomes.
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2021, Vol. 20 
