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01-09-2020 | Portal Vein Thrombosis | Original Scientific Report

Massage of the Hepatoduodenal Ligament Recovers Portal Vein Flow Immediately After the Pringle Maneuver in Hepatectomy

Authors: Junji Ueda, Yasuhiro Mamada, Nobuhiko Taniai, Masato Yoshioka, Atsushi Hirakata, Youichi Kawano, Tetsuya Shimizu, Tomohiro Kanda, Hideyuki Takata, Ryota Kondo, Yohei Kaneya, Yuto Aoki, Hiroshi Yoshida

Published in: World Journal of Surgery | Issue 9/2020

Abstract

Background

The Pringle maneuver is often used in liver surgery to minimize bleeding during liver transection. Many authors have demonstrated that intermittent use of the Pringle maneuver is safe and effective when performed appropriately. However, some studies have reported that the Pringle maneuver is a significant risk factor for portal vein thrombosis. In this study, we evaluated the effectiveness of portal vein flow after the Pringle maneuver and the impact that massaging the hepatoduodenal ligament after the Pringle maneuver has on portal vein flow.

Materials and Methods

Patients treated with the Pringle maneuver for hepatectomies performed to treat hepatic disease at our hospital between August 2014 and March 2019 were included in the study (N = 101). We divided these patients into two groups, a massage group and nonmassage group. We measured portal vein blood flow with ultrasonography before and after clamping of the hepatoduodenal ligament. We also evaluated laboratory data after the hepatectomy.

Results

Portal vein flow was significantly lower after the Pringle maneuver than before clamping of the hepatoduodenal ligament. The portal vein flow after the Pringle maneuver was improved following massage of the hepatoduodenal ligament. After hepatectomy, serum prothrombin time was significantly higher and serum C-reactive protein was significantly lower in the massage group than in the nonmassage group.

Conclusion

Massaging the hepatoduodenal ligament after the Pringle maneuver is recommended in order to quickly recover portal vein flow during hepatectomy and to improve coagulability.

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Title: Massage of the Hepatoduodenal Ligament Recovers Portal Vein Flow Immediately After the Pringle Maneuver in Hepatectomy
Authors: Junji Ueda
Yasuhiro Mamada
Nobuhiko Taniai
Masato Yoshioka
Atsushi Hirakata
Youichi Kawano
Tetsuya Shimizu
Tomohiro Kanda
Hideyuki Takata
Ryota Kondo
Yohei Kaneya
Yuto Aoki
Hiroshi Yoshida
Publication date: 01-09-2020
Publisher: Springer International Publishing
Keywords: Portal Vein Thrombosis
Portal Vein Thrombosis
Massage
Published in: World Journal of Surgery / Issue 9/2020
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-020-05570-7

At a glance: The STEP trials

Springer Medicine

Massage of the Hepatoduodenal Ligament Recovers Portal Vein Flow Immediately After the Pringle Maneuver in Hepatectomy

Abstract

Background

Materials and Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Materials and Methods

Results

Conclusion

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