Pringle's maneuver lasting 322 min.
Pringle's maneuver lasting 322 min.
复制标题
普林格尔机动持续 322 分钟。
作者：
Yoshihiro Sakamoto;Masatoshi Makuuchi;T. Takayama;M. Minagawa;Yoshiaki Kita
到目前为止，肝切除术中“连续”Pringle手法的报道限度尚未超过127分钟。在这里，我们使用“间歇”钳夹来增加安全缺血的累积时间。一位49岁男性因平滑肌肉瘤而接受空肠切除术，并被转诊为18处肝转移。使用“间歇性”Pringle手法，进行整个肿瘤的摘除。肝脏的累积缺血时间为322分钟，但术后血清总胆红素水平保持正常。患者于第24天出院，无任何并发症，术后5个月保持良好。本病例表明，累积肝缺血的安全上限可延长至322分钟。
Up to now, the reported limit of 'continuous' Pringle's maneuver during hepatectomy has not exceeded 127 min. Here we used 'intermittent' clamping to increase the cumulative time of safe ischemia. A 49 year-old man who had undergone jejunal resection because of leiomyosarcoma was referred with 18 hepatic metastases. Using 'intermittent' Pringle's maneuver, enucleation of the entire tumor was performed. The cumulative ischemic time of the liver was 322 min, but post-operative serum level total bilirubin remained normal. The patient was discharged on day 24 without any complications, remaining well for up to 5 months after surgery. The present case shows that the safe upper limit of cumulative hepatic ischemia can be extended to 322 min.