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Article: Effects of the intermittent Pringle manoeuvre on hepatic gene expression and ultrastructure in a randomized clinical study

TitleEffects of the intermittent Pringle manoeuvre on hepatic gene expression and ultrastructure in a randomized clinical study
Authors
Issue Date2003
PublisherJohn Wiley & Sons Ltd. The Journal's web site is located at http://www.bjs.co.uk
Citation
British Journal Of Surgery, 2003, v. 90 n. 2, p. 183-189 How to Cite?
AbstractBackground: The intermittent Pringle manoeuvre during hepatectomy results in a better clinical outcome when the accumulated ischaemia time is less than 120 min. The aim of this study was to investigate hepatic gene expression related to microcirculatory modulation and ultrastructural changes in patients having the intermittent Pringle manoeuvre. Methods: Forty patients who underwent hepatectomy for liver tumours were randomly assigned to liver transection with intermittent Pringle manoeuvre (Pringle group, n = 20) or without the manoeuvre (control group, n = 20). The clinical data and hepatic expression of endothelin (ET) 1 and endothelial nitric oxide synthase (eNOS) combined with liver ultrastructure were compared. Results: The Pringle manoeuvre resulted in less blood loss (8.9 versus 12.4 ml/cm2; P = 0.034), a shorter transection time (2.7 versus 4.1 min/cm2; P = 0.015) and a lower serum bilirubin level on postoperative day 2 (26 versus 35 μm/l; P = 0.04). The hepatic messenger RNA content of ET-1 decreased by 38 per cent of the basal level in the Pringle group, whereas it increased by 28 per cent in the control group (P = 0.026). More patients in the control group showed swelling of mitochondria in hepatocytes and disruption of sinusoidal lining cells (12 of 20 patients versus three of 20 in the Pringle group; P = 0.008). Conclusion: The intermittent Pringle manoeuvre results in less disturbance of the hepatic microcirculation and better preservation of liver sinusoids after hepatectomy.
Persistent Identifierhttp://hdl.handle.net/10722/88518
ISSN
2015 Impact Factor: 5.596
2015 SCImago Journal Rankings: 2.966
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorMan, Ken_HK
dc.contributor.authorLo, CMen_HK
dc.contributor.authorLiu, CLen_HK
dc.contributor.authorZhang, ZWen_HK
dc.contributor.authorLee, TKWen_HK
dc.contributor.authorNg, IOLen_HK
dc.contributor.authorFan, STen_HK
dc.contributor.authorWong, Jen_HK
dc.date.accessioned2010-09-06T09:44:25Z-
dc.date.available2010-09-06T09:44:25Z-
dc.date.issued2003en_HK
dc.identifier.citationBritish Journal Of Surgery, 2003, v. 90 n. 2, p. 183-189en_HK
dc.identifier.issn0007-1323en_HK
dc.identifier.urihttp://hdl.handle.net/10722/88518-
dc.description.abstractBackground: The intermittent Pringle manoeuvre during hepatectomy results in a better clinical outcome when the accumulated ischaemia time is less than 120 min. The aim of this study was to investigate hepatic gene expression related to microcirculatory modulation and ultrastructural changes in patients having the intermittent Pringle manoeuvre. Methods: Forty patients who underwent hepatectomy for liver tumours were randomly assigned to liver transection with intermittent Pringle manoeuvre (Pringle group, n = 20) or without the manoeuvre (control group, n = 20). The clinical data and hepatic expression of endothelin (ET) 1 and endothelial nitric oxide synthase (eNOS) combined with liver ultrastructure were compared. Results: The Pringle manoeuvre resulted in less blood loss (8.9 versus 12.4 ml/cm2; P = 0.034), a shorter transection time (2.7 versus 4.1 min/cm2; P = 0.015) and a lower serum bilirubin level on postoperative day 2 (26 versus 35 μm/l; P = 0.04). The hepatic messenger RNA content of ET-1 decreased by 38 per cent of the basal level in the Pringle group, whereas it increased by 28 per cent in the control group (P = 0.026). More patients in the control group showed swelling of mitochondria in hepatocytes and disruption of sinusoidal lining cells (12 of 20 patients versus three of 20 in the Pringle group; P = 0.008). Conclusion: The intermittent Pringle manoeuvre results in less disturbance of the hepatic microcirculation and better preservation of liver sinusoids after hepatectomy.en_HK
dc.languageengen_HK
dc.publisherJohn Wiley & Sons Ltd. The Journal's web site is located at http://www.bjs.co.uken_HK
dc.relation.ispartofBritish Journal of Surgeryen_HK
dc.rightsBritish Journal of Surgery. Copyright © John Wiley & Sons Ltd.en_HK
dc.subject.meshAdulten_HK
dc.subject.meshAgeden_HK
dc.subject.meshEndothelin-1 - genetics - metabolismen_HK
dc.subject.meshFemaleen_HK
dc.subject.meshGene Expressionen_HK
dc.subject.meshHepatectomy - methodsen_HK
dc.subject.meshHumansen_HK
dc.subject.meshImmunohistochemistryen_HK
dc.subject.meshLigationen_HK
dc.subject.meshLiver Neoplasms - blood supply - surgery - ultrastructureen_HK
dc.subject.meshMaleen_HK
dc.subject.meshMicroscopy, Electronen_HK
dc.subject.meshMiddle Ageden_HK
dc.subject.meshNitric Oxide Synthase - genetics - metabolismen_HK
dc.subject.meshNitric Oxide Synthase Type IIen_HK
dc.subject.meshNitric Oxide Synthase Type IIIen_HK
dc.titleEffects of the intermittent Pringle manoeuvre on hepatic gene expression and ultrastructure in a randomized clinical studyen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0007-1323&volume=90&spage=183&epage=189&date=2003&atitle=Effects+of+the+intermittent+pringle+manoeuvre+on+hepatic+gene+expression+and+ultrastructure+in+a+randomized+clinical+studyen_HK
dc.identifier.emailMan, K: kwanman@hku.hken_HK
dc.identifier.emailLo, CM: chungmlo@hkucc.hku.hken_HK
dc.identifier.emailLee, TKW: tkwlee@hkucc.hku.hken_HK
dc.identifier.emailNg, IOL: iolng@hku.hken_HK
dc.identifier.emailFan, ST: stfan@hku.hken_HK
dc.identifier.emailWong, J: jwong@hkucc.hku.hken_HK
dc.identifier.authorityMan, K=rp00417en_HK
dc.identifier.authorityLo, CM=rp00412en_HK
dc.identifier.authorityLee, TKW=rp00447en_HK
dc.identifier.authorityNg, IOL=rp00335en_HK
dc.identifier.authorityFan, ST=rp00355en_HK
dc.identifier.authorityWong, J=rp00322en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1002/bjs.4027en_HK
dc.identifier.pmid12555294-
dc.identifier.scopuseid_2-s2.0-0037326916en_HK
dc.identifier.hkuros76919en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0037326916&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume90en_HK
dc.identifier.issue2en_HK
dc.identifier.spage183en_HK
dc.identifier.epage189en_HK
dc.identifier.isiWOS:000182437500009-
dc.publisher.placeUnited Kingdomen_HK
dc.identifier.scopusauthoridMan, K=7101754072en_HK
dc.identifier.scopusauthoridLo, CM=7401771672en_HK
dc.identifier.scopusauthoridLiu, CL=7409789712en_HK
dc.identifier.scopusauthoridZhang, ZW=8574700400en_HK
dc.identifier.scopusauthoridLee, TKW=7501439435en_HK
dc.identifier.scopusauthoridNg, IOL=7102753722en_HK
dc.identifier.scopusauthoridFan, ST=7402678224en_HK
dc.identifier.scopusauthoridWong, J=8049324500en_HK

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