We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Does Intermittent Pringle Maneuver Increase Postoperative Complications After Hepatectomy for Hepatocellular Carcinoma? A Randomized Controlled Trial.
- Authors
Lee, Kit Fai; Wong, John; Cheung, Sunny Y. S.; Chong, Charing C. N.; Hui, Joyce W. Y.; Leung, Vivian Y. F.; Yu, Simon C. H.; Lai, Paul B. S.
- Abstract
Background: In a previous study, we have shown that intermittent Pringle maneuver (IPM) might increase postoperative complications after hepatectomy for various indications. Complications which thought to be related to IPM were ascites, pleural effusion, wound infection and intra-abdominal collection. The aim of this study was to test the hypothesis that applying IPM during hepatectomy for hepatocellular carcinoma (HCC) could increase postoperative complications.Methods: Between January 2013 and October 2016, eligible patients who received elective open hepatectomy for HCC were randomized to have IPM or no Pringle maneuver (NPM). Occurrence of various types of postoperative complications was specifically looked for. A routine postoperative day 5 abdominal ultrasound examination and chest X-ray were done to detect and grade any radiological ascites, pleural effusion and intra-abdominal collection.Results: Fifty IPM and 50 NPM patients with histological proven HCC were recruited for final analysis. Demographics and operative parameters were comparable between the two groups. The postoperative complication rates were similar (IPM 36.0 vs. NPM 28.0%, P = 0.391). However, in the IPM group, more patients developed radiological posthepatectomy ascites (42.0 vs. 22.0%, P = 0.032) and pleural effusion (66.0 vs. 38.0%, P = 0.005). In patients with histologically proven cirrhosis, there were 28 IPM and 25 NPM patients. Again, there was no difference in postoperative complication rate but more radiological posthepatectomy ascites and pleural effusion in the IPM group.Conclusion: This trial was not able to detect a difference in postoperative complications whether IPM was applied or not, but use of IPM was associated with more subclinical ascites and pleural effusion. (ClinicalTrials.gov NCT01759901).Trial registration number: ClinicalTrials.gov NCT01759901.
- Subjects
HEPATECTOMY; SURGICAL excision; LIVER surgery; ASCITES; SURGICAL complications
- Publication
World Journal of Surgery, 2018, Vol 42, Issue 10, p3302
- ISSN
0364-2313
- Publication type
Article
- DOI
10.1007/s00268-018-4637-3