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Long-Term Effects of Pedicle Clamping during Major Hepatectomy for Colorectal Liver Metastases

Authors :
Peter Lodge
Piotr Krawczyk
Marcin Morawski
Michał Grąt
Philipp Kron
Damian Sieńko
Maciej Krasnodębski
University of Zurich
Morawski, Marcin
Source :
Journal of Clinical Medicine, Vol 10, Iss 2778, p 2778 (2021), Journal of Clinical Medicine, Volume 10, Issue 13
Publication Year :
2021
Publisher :
MDPI AG, 2021.

Abstract

The use of the Pringle maneuver (PM) varies widely among surgical departments. Its use depends on the operator and type of liver resection. The aim of this study was to determine the impact of the PM on patient outcomes when undergoing major liver resections. This retrospective study comprised 179 colorectal liver metastasis patients from two liver centers from Leeds and Warsaw. Only right or right extended hepatectomies with negative oncological margins were included. The primary outcome measure was the 5-year overall survival (OS). The PM was applied during 60 (33.5%) major hepatectomies included in the study and was associated with a higher peak 3-day postoperative bilirubin concentration (p = 0.002), yet not with the peak 3-day alanine aminotransferase activity (p = 0.415). The 5-year OS after liver resections with the PM and without the PM were 55.0% and 33.4%, respectively (p = 0.019). Following stratification by the Tumor Burden Score, after resections with the use of the PM, superior survival was particularly found in the subgroup of patients at intermediate risk of recurrence (p = 0.004). However, the use of the PM had no significant effect on the 5-year overall survival following adjustment for the confounding effect of the carcinoembryonic antigen concentration (p = 0.265). The use of the PM had no negative effects on the long-term outcomes in patients undergoing major, oncologically radical liver resections for colorectal metastases.

Details

Language :
English
ISSN :
20770383
Volume :
10
Issue :
2778
Database :
OpenAIRE
Journal :
Journal of Clinical Medicine
Accession number :
edsair.doi.dedup.....b5cf26a21fdac86fedbe5e07ad0c53e5