Affiliations: Institute of Surgery, Department of Operative Techniques and Surgical Research, Medical and Health Science Centre, Faculty of Medicine, University of Debrecen, Hungary | Institute of Surgery, Augusta Surgical Centre, Medical and Health Science Centre, Faculty of Medicine, University of Debrecen, Hungary
Note: [] Corresponding author: Norbert Nemeth, MD, PhD, Department of Operative Techniques and Surgical Research, Medical and Health Science Centre, University of Debrecen, H-4032 Debrecen, Nagyerdei krt. 98, Hungary. Tel./Fax: +36 52 416 915; E-mail: nemeth@med.unideb.hu.
Abstract: In liver resection operations the Pringle (Baron) maneuver can be used for temporary ischemia by clamping the hepatoduodenal ligament intermittently. In this beagle canine model we investigated whether hemorheological parameters may alter in systemic, portal and hepatic venous blood and in arterial samples during–after Pringle maneuvers. In Pringle Group unilateral femoral artery and external jugular vein were cannulated. From median laparotomy the hepatoduodenal ligament was exposed. The portal venous system was catheterized via a mesenteric vein and through the inferior caval vein a catheter was led to the hepatic veins. After stabilization, a 15-minute Pringle maneuver was carried out three times with 5-minute interpolated reperfusion periods. In Control Group Pringle maneuvers were not made. Before and after Pringle maneuvers parallel blood samples were taken from the cannulated vessels for determining hematological parameters and erythrocyte aggregation. Following Pringle maneuvers erythrocyte deformability, blood and plasma viscosity were also tested. The results showed that besides systemic hemorheological effects of the intermittent Pringle maneuver local leukocyte count, hematocrit and erythrocyte aggregation index altered mainly in portal venous blood, depending on the repeating number of the maneuvers. Thus, investigations of hemorheological parameters might be useful to determine the optimal duration of the Pringle maneuver.
