ArticleArquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery2026
Impacts of pringle maneuver on hepatectomies: analysis of survival and clinical effects.
Article in Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Intraoperative cerebral desaturation during low-central-venous-pressure hepatectomy with intermittent Pringle maneuver: a case report.Frontiers in medicine · 2026Article
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4 authors.
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Abstract
backgroundThe Pringle maneuver remains a widely used technique in hepatic surgery with varying opinions on its effects on postoperative outcomes and survival, requiring evidence-based evaluation of its impact on liver function and long-term results.
aimsThe aim of this study was to evaluate the impact of the intermittent Pringle maneuver on postoperative liver function and survival in hepatectomy patients, focusing on early dysfunction markers as prognostic factors.
resultsIn this retrospective cohort of 198 patients (106 women and 92 men; mean age, 59 years), the Pringle group showed longer surgical times (226.87±82.18 vs. 184.00±80.90 min, p<0.001) and extended intensive care unit stays (4.02±2.1 vs 3.11±1.9 days, p=0.026), but lower bilirubin levels (2.18±0.33 vs. 3.13±0.39 mg/dL, p=0.049). Multivariate analysis revealed that the Pringle maneuver reduced mortality risk (hazard ratio [HR]=0.540, 95% confidence interval [95%CI]: 0.333-0.876, p=0.013). Early liver dysfunction markers strongly predicted worse outcomes: elevated bilirubin nearly doubled mortality risk (HR 1.975, 95%CI 1.100-3.545, p=0.023), and decreased prothrombin activity tripled it (HR 3.055, 95%CI 1.839-5.075, p<0.001).
conclusionsWhile the Pringle maneuver extends operative time and intensive care unit stay, it demonstrates a protective effect on survival. Early postoperative liver dysfunction strongly predicts poor outcomes, emphasizing the importance of careful postoperative monitoring regardless of vascular control strategy. These findings suggest that a controlled intermittent Pringle maneuver offers survival benefits when properly timed.
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