Tolerance of the Liver to Intermittent Pringle Maneuver in Hepatectomy for Liver Tumors

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Abstract
HEPATIC VASCULAR control is used by many surgeons to prevent massive hemorrhage during hepatectomy. The hepatic vascular inflow occlusion provides a relatively bloodless operative field and allows an unhurried, meticulous, and accurate intrahepatic dissection and hemostasis. There is always a risk of ischemic damage to the hepatocytes, however, especially in patients with chronic liver disease, the degree of which is likely to be accentuated with a prolonged period of vascular inflow occlusion. Within the period of ischemia that the liver can tolerate, the liver can recover from the operative and ischemic injury. Otherwise, a deterioration of liver function will ensue. The duration of the liver's tolerance to the Pringle maneuver remains the major concern of liver surgeons. We did this study to define the duration of Pringle maneuver that the liver can tolerate without substantial posthepatectomy injury.