Affiliations: Department of General, Visceral and Vascular Surgery, Hospital Worms, Worms, Germany | Department of General, Visceral, Vascular and Paediatric Surgery, University Hospital of the Saarland, Homburg/Saar, Germany | Institute of Clinical Hemostaseology and Transfusion Medicine, University Hospital of the Saarland, Homburg/Saar, Germany | Department of Medical Statistics, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
Note: [] Corresponding author: Dr. M. Weinrich, Department of General, Visceral and Vascular Surgery, Hospital Worms, Gabriel-von-Seidl-Straße 81, D-67550 Worms, Germany. Tel.: +49 6241 501 3102; Fax: +49 6241 501 3199; E-mail: malte.weinrich@gmx.de.
Abstract: Introduction: To reduce intraoperative blood loss in liver resections surgical bleeding control is often performed by a complete inflow obstruction of the liver called Pringle manoeuvre leading to a portal venous stasis. Platelet aggregability may be affected by this circulatory stasis. Materials and methods: A study population of 11 patients (37–67 years old, 7 females and 4 males) with hepatic tumours underwent elective liver resection. Pringle manoeuvre of up to 50 min duration was used in 4 patients. The other 7 patients were operated using selective vascular clamping. Platelets were aggregated before and after liver resection with adenosine diphosphate, collagen and ristocetin (according to Born). Results: Mean maximal amplitudes of platelet aggregation were comparable before and after liver resection. Statistic analysis did not detect a significant difference between the values before and after liver resection as well as between Pringle manoeuvre and selective vascular clamping. Conclusion: Induced platelet aggregability is not affected by the method of surgical bleeding control used in liver resection. Platelet aggregability seems to be resistant even to portal venous stasis of up to 50 min during Pringle manoeuvre.
