Modified Pringle Maneuver Applicable for Laparoscopic Hepatectomy.

Modified Pringle Maneuver Applicable for Laparoscopic Hepatectomy.
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改良 Pringle 操作适用于腹腔镜肝切除术。

DOI：
10.1097/sle.0000000000000117
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发表时间：
2014
期刊：
Surgical laparoscopy, endoscopy & percutaneous techniques
影响因子：
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通讯作者：
I. Takeyoshi
I. Takeyoshi
中科院分区：
--
文献类型：
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作者：
Y. Sunose;K. Hirai;S. Nakazawa;D. Yoshinari;Hiroomi Ogawa;H. Tsukagoshi;Norifumi Takahashi;Hodaka Yamazaki;Yoko Motegi;Yohei Miyamae;T. Igarashi;Kengo Takahashi;R. Katoh;Kazumi Tanaka;I. Takeyoshi

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介绍 我们提出了一种广泛适用的技术，改良普林格尔手法，以减少失血腹腔镜肝切除术。 方法 我们用一根输液管绕在肝十二指肠韧带上。在改良的Pringle手法①（m-Pringle ①）中，我们使用60 cm长的管。从脐带端口的侧面引出管的两端，然后用皮安钳拉动并夹住以中断血流。在改良Pringle手法②（m-Pringle ②）中，我们使用一个20 cm长的管，两端系有丝线。以相同的方式将线引至腹膜外。 结果 尽管血流被充分阻断，但m-Pringle ①组60例中有14例发生CO2泄漏。10例患者均采用m-Pringle ②阻断血流，维持腹腔内压。 结论 这些操作不需要额外的端口，并且管的拉动和释放很容易从体外执行。
INTRODUCTION We present a widely applicable technique of the modified Pringle maneuver to reduce blood loss for laparoscopic hepatectomy. METHODS We use a drip-infusion tube and wrap it around the hepatoduodenal ligament. In the modified Pringle maneuver ① (m-Pringle ①), we use a 60 cm long tube. Both ends of the tube are led out from the side of the umbilical port, then pulled and clipped with Pean forceps to interrupt blood flow. In the modified Pringle maneuver ② (m-Pringle ②), we use a 20 cm long tube with silk threads tied at both ends. The threads were led extraperitoneally in the same manner. RESULTS Although blood flow was sufficiently interrupted, CO2 leak occurred in 14 of 60 cases in m-Pringle ①. Blood flow was interrupted and intra-abdominal pressure was kept in all 10 patients in m-Pringle ②. CONCLUSIONS These maneuvers require no extra port, and tube pulling and releasing is readily performed from outside the body.