Hepatectomy with the Pringle Maneuver Exceeding 60 Minutes in Patients with Mild Liver Cirrhosis

Abstract

Massive bleeding during hepatectomy often results in serious consequences, particularly in patients with cirrhosis. To minimize hemorrhage, it would seem reasonable to occlude vascular inflow for as long as needed. We treated three patients with advanced hepatocellular carcinoma in association with early stage of liver cirrhosis using the "uninterrupted" Pringle manuever for more than one hour. The tolerance of a cirrhotic liver to long-term warm ischemia is discussed.