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Article: Effects of the intermittent Pringle manoeuvre on hepatic gene expression and ultrastructure in a randomized clinical study
Title | Effects of the intermittent Pringle manoeuvre on hepatic gene expression and ultrastructure in a randomized clinical study |
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Authors | |
Issue Date | 2003 |
Publisher | John 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? |
Abstract | Background: 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 Identifier | http://hdl.handle.net/10722/88518 |
ISSN | 2023 Impact Factor: 8.6 2023 SCImago Journal Rankings: 2.148 |
ISI Accession Number ID | |
References |
DC Field | Value | Language |
---|---|---|
dc.contributor.author | Man, K | en_HK |
dc.contributor.author | Lo, CM | en_HK |
dc.contributor.author | Liu, CL | en_HK |
dc.contributor.author | Zhang, ZW | en_HK |
dc.contributor.author | Lee, TKW | en_HK |
dc.contributor.author | Ng, IOL | en_HK |
dc.contributor.author | Fan, ST | en_HK |
dc.contributor.author | Wong, J | en_HK |
dc.date.accessioned | 2010-09-06T09:44:25Z | - |
dc.date.available | 2010-09-06T09:44:25Z | - |
dc.date.issued | 2003 | en_HK |
dc.identifier.citation | British Journal Of Surgery, 2003, v. 90 n. 2, p. 183-189 | en_HK |
dc.identifier.issn | 0007-1323 | en_HK |
dc.identifier.uri | http://hdl.handle.net/10722/88518 | - |
dc.description.abstract | Background: 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.language | eng | en_HK |
dc.publisher | John Wiley & Sons Ltd. The Journal's web site is located at http://www.bjs.co.uk | en_HK |
dc.relation.ispartof | British Journal of Surgery | en_HK |
dc.rights | British Journal of Surgery. Copyright © John Wiley & Sons Ltd. | en_HK |
dc.subject.mesh | Adult | en_HK |
dc.subject.mesh | Aged | en_HK |
dc.subject.mesh | Endothelin-1 - genetics - metabolism | en_HK |
dc.subject.mesh | Female | en_HK |
dc.subject.mesh | Gene Expression | en_HK |
dc.subject.mesh | Hepatectomy - methods | en_HK |
dc.subject.mesh | Humans | en_HK |
dc.subject.mesh | Immunohistochemistry | en_HK |
dc.subject.mesh | Ligation | en_HK |
dc.subject.mesh | Liver Neoplasms - blood supply - surgery - ultrastructure | en_HK |
dc.subject.mesh | Male | en_HK |
dc.subject.mesh | Microscopy, Electron | en_HK |
dc.subject.mesh | Middle Aged | en_HK |
dc.subject.mesh | Nitric Oxide Synthase - genetics - metabolism | en_HK |
dc.subject.mesh | Nitric Oxide Synthase Type II | en_HK |
dc.subject.mesh | Nitric Oxide Synthase Type III | en_HK |
dc.title | Effects of the intermittent Pringle manoeuvre on hepatic gene expression and ultrastructure in a randomized clinical study | en_HK |
dc.type | Article | en_HK |
dc.identifier.openurl | http://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+study | en_HK |
dc.identifier.email | Man, K: kwanman@hku.hk | en_HK |
dc.identifier.email | Lo, CM: chungmlo@hkucc.hku.hk | en_HK |
dc.identifier.email | Lee, TKW: tkwlee@hkucc.hku.hk | en_HK |
dc.identifier.email | Ng, IOL: iolng@hku.hk | en_HK |
dc.identifier.email | Fan, ST: stfan@hku.hk | en_HK |
dc.identifier.email | Wong, J: jwong@hkucc.hku.hk | en_HK |
dc.identifier.authority | Man, K=rp00417 | en_HK |
dc.identifier.authority | Lo, CM=rp00412 | en_HK |
dc.identifier.authority | Lee, TKW=rp00447 | en_HK |
dc.identifier.authority | Ng, IOL=rp00335 | en_HK |
dc.identifier.authority | Fan, ST=rp00355 | en_HK |
dc.identifier.authority | Wong, J=rp00322 | en_HK |
dc.description.nature | link_to_subscribed_fulltext | - |
dc.identifier.doi | 10.1002/bjs.4027 | en_HK |
dc.identifier.pmid | 12555294 | - |
dc.identifier.scopus | eid_2-s2.0-0037326916 | en_HK |
dc.identifier.hkuros | 76919 | en_HK |
dc.relation.references | http://www.scopus.com/mlt/select.url?eid=2-s2.0-0037326916&selection=ref&src=s&origin=recordpage | en_HK |
dc.identifier.volume | 90 | en_HK |
dc.identifier.issue | 2 | en_HK |
dc.identifier.spage | 183 | en_HK |
dc.identifier.epage | 189 | en_HK |
dc.identifier.isi | WOS:000182437500009 | - |
dc.publisher.place | United Kingdom | en_HK |
dc.identifier.scopusauthorid | Man, K=7101754072 | en_HK |
dc.identifier.scopusauthorid | Lo, CM=7401771672 | en_HK |
dc.identifier.scopusauthorid | Liu, CL=7409789712 | en_HK |
dc.identifier.scopusauthorid | Zhang, ZW=8574700400 | en_HK |
dc.identifier.scopusauthorid | Lee, TKW=7501439435 | en_HK |
dc.identifier.scopusauthorid | Ng, IOL=7102753722 | en_HK |
dc.identifier.scopusauthorid | Fan, ST=7402678224 | en_HK |
dc.identifier.scopusauthorid | Wong, J=8049324500 | en_HK |
dc.identifier.issnl | 0007-1323 | - |