What is a modified Pringle maneuver?

Background: The Pringle maneuver is widely used in liver surgery to reduce intraoperative blood loss. However, total vascular inflow occlusion is frequently associated with ischemia reperfusion injury leading to postoperative liver dysfunction and impaired recovery.

How is Pringle maneuver performed?

The surgeon makes one or more incisions in the stomach depending on the type of surgery. The surgeon finds the hepatic vascular pedicle, lifts it up and applies the clamp. Pringle maneuver may be applied intermittently in 10- to 20-minute cycles, allowing five minutes of blood flow (reperfusion) in between.

Which of the following structure is compressed during Pringle maneuver?

In 1908, Pringle first described a technique to minimize blood loss during hepatic surgery by clamping the vascular pedicle (now commonly known as the Pringle maneuver).

How do you do Perihepatic packing?

The technique of perihepatic packing involves manual closure or approximation of the parenchyma, followed by the consecutive placing of dry abdominal packs around the liver and straight over the injury in an attempt to provide tamponade to a bleeding site.

What is clamped in the Pringle maneuver?

The Pringle manouvre consists in clamping the hepatoduodenal ligament (the free border of the lesser omentum). This interrupts the flow of blood through the hepatic artery and the portal vein, which helps to control bleeding from the liver. The common bile duct is also temporarily closed during this procedure.

How long can you do Pringle maneuver?

Conclusion The upper limit of tolerance of the liver to intermittent Pringle maneuver is 120 minutes.

When is Pringle maneuver used?

Uses. The Pringle manoeuvre is used during liver surgery and in some cases of severe liver trauma to minimize blood loss. For short durations of use, it is very effective at reducing intraoperative blood loss. The Pringle manoeuvre is applied during closure of a vena cava injury when an atriocaval shunt is placed.

What is clamped during the Pringle maneuver?

The Pringle manoeuvre is a surgical technique used in some abdominal operations. The hepatoduodenal ligament is clamped either with a surgical tool called a haemostat or by hand. This limits blood flow through the hepatic artery and the portal vein, controlling bleeding from the liver.

What is a liver injury?

Acute liver failure is loss of liver function that occurs rapidly — in days or weeks — usually in a person who has no preexisting liver disease. It’s most commonly caused by a hepatitis virus or drugs, such as acetaminophen. Acute liver failure is less common than chronic liver failure, which develops more slowly.

What is Hematobilia?

Hemobilia refers to bleeding from and/or into the biliary tract and is an uncommon but important cause of gastrointestinal hemorrhage.