Pringle manoeuvre during hepatectomy

Abstract

Massive haemorrhage has always been a major problem in hepatectomy. Many surgical techniques have been tried to arrest the possible torrential bleeding during liver operation. Amongst all methods of hepatic vascular control, Pringle manoeuvre is most frequently employed by the liver surgeons because it is technically easy to apply. The fear that Pringle manoeuvre may lead to a deterioration of liver function has prevented it from receiving popular clinical application for nearly 60 years. This literature review summarizes the classification of the different hepatic vascular control methods and compares them with Pringle manoeuvre. The hepatic functional and morphological changes under Pringle manoeuvre, the benefits and adverse effects of the clinical outcome, the influence on systemic and hepatic intracellular response in acute phase under stress of operation, and the ischaemia-reperfusion injury that are induced by the Pringle manoeuvre will be discussed.