Hepatectomy using traditional Péan clamp–crushing technique under intermittent Pringle maneuver

Abstract 

Background

The clamp-crushing technique has been proved to be the most cost-efficient approach for hepatectomy. If the advantageous characteristics, such as lower blood loss and morbidity, could be utilized, this method could be ideal.

Methods

The records of 380 patients who underwent hepatectomy using the clamp-crushing technique with intermittent inflow occlusion between 2002 and 2006 were retrospectively reviewed. One hundred fifty patients underwent major hepatectomy, and 230 underwent minor hepatectomy.

Results

Thirteen (3.4%) patients received red cell transfusion, and 21 (5.5%) patients received fresh frozen plasma. According to Clavien's classification system, grade I complications occurred in 42 (11.1%), grade II in 32 (8.4%), grade III in 14 (3.7%), grade IV in 1 (0.3%), and grade V in 2 (0.5%) patients. Female sex, preoperative albumin-to-globulin ratio, and type of resection were independent factors predictive of blood loss.

Conclusions

The present patient series, who underwent traditional Péan clamp–crushing technique under intermittent Pringle maneuver, had a low risk of complications. This procedure is an acceptable technique for hepatic parenchymal transection.

Keywords: Blood loss, Blood transfusion, Clamp-crushing technique, Fresh frozen plasma, Hepatectomy, Morbidity, Mortality