Authors: Yu Zhang Hongji Yang Xiaofan Deng Yunfei Chen Shikai Zhu Chen Kai
Publish Date: 2015/06/20
Volume: 30, Issue: 3, Pages: 961-970
Abstract
Despite accumulated experience and advancing techniques for laparoscopic hepatectomy bleeding remains the major concern during parenchymal transection The vascular inflow control technique is still important to decrease intraoperative blood loss The objective of this study was to compare intermittent Pringle with continuous hemihepatic vascular inflow occlusion using extraglissonian approach in laparoscopic liver resectionBetween January 2011 and January 2015 a total of 79 consecutive patients with tumors locating either in the right or in the left hemiliver were included into this retrospective study 45 in the Pringle group vs 34 in the halfPringle group Preoperative clinical characteristics intraoperative details postoperative complications and outcomes of patients were comparedThe two groups were well matched according to clinical characteristics tumor features types of liver resection and histopathology P 005 The mean operative time 2475 ± 613 vs 2214 ± 487 min P = 00446 ischemic duration 628 ± 283 vs 441 ± 205 min P = 00017 and overall declamping time 212 ± 82 vs 09 ± 19 min P 005 were significantly longer in the Pringle group than in the halfPringle group The mean amount of intraoperative blood loss 5682 ± 3251 vs 4207 ± 3072 mL P = 00444 and transfusion 2661 ± 1234 vs 2032 ± 1446 mL P = 00406 were significantly greater in the Pringle group The overall operative morbidity rate was significantly higher in the Pringle group 40 vs 176 P = 00324 The Pringle group was associated with significantly higher alanine aminotransferase and aspartate transaminase levels on postoperative day POD 7 and lower albumin levels on PODs 1 and 3 P 005 The Creactive protein levels were significantly higher in the Pringle group than in the halfPringle group on POD 1 375 ± 214 vs 282 ± 190 mg/L P = 00484 POD 3 1140 ± 534 vs 906 ± 479 mg/L P = 00474 and POD 7 549 ± 298 vs 401 ± 264 mg/L P = 00245
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