Intermittent Pringle manoeuvre is not associated with adverse long-term prognosis after resection for colorectal liver metastases

Br J Surg. 2008 Aug;95(8):985-9. doi: 10.1002/bjs.6129.

Abstract

Background: Intermittent clamping of the porta hepatis, or the intermittent Pringle manoeuvre (IPM), is often used to control inflow during parenchymal liver transection. The aim of this study was to determine whether IPM is associated with an adverse long-term outcome after liver resection for colorectal liver metastasis (CRLM).

Methods: All patients undergoing resection for CRLM in 1993-2006, for whom data on IPM were recorded, were included in the study. A total of 563 patients was available for analysis.

Results: IPM was performed in 289 (51.3 per cent) of the patients. The duration of IPM ranged from 2 to 104 (median 22) min. There were no differences in clinicopathological features or postoperative morbidity between patients who had an IPM and those who did not. The median survival of patients undergoing IPM was 55.7 months compared with 48.9 months in those not having an IPM (P = 0.406). There was no difference in median disease-free survival between the two groups (22.1 versus 19.9 months respectively; P = 0.199).

Conclusion: IPM is not associated with an adverse long-term prognosis in patients undergoing liver resection for CRLM.

MeSH terms

  • Aged
  • Blood Loss, Surgical / prevention & control
  • Colorectal Neoplasms*
  • Constriction
  • Epidemiologic Methods
  • Female
  • Hepatectomy / adverse effects*
  • Hepatectomy / methods
  • Humans
  • Liver Neoplasms / mortality
  • Liver Neoplasms / secondary
  • Liver Neoplasms / surgery*
  • Male
  • Prognosis
  • Treatment Outcome