Autologous Blood Transfusion and Pringle Maneuver in Laparoscopic Segmental Hepatectomy for Benign Hepatic Neoplasms: A Retrospective Study

J Laparoendosc Adv Surg Tech A. 2019 Dec;29(12):1571-1576. doi: 10.1089/lap.2019.0407. Epub 2019 Nov 4.

Abstract

Objectives: To investigate the effect of autologous blood transfusion (ABT) and Pringle maneuver (PM) on postoperative early liver function and short-term postoperative results following laparoscopic liver resection in patients with benign hepatic neoplasms. Materials and Methods: We retrospectively analyzed the clinical data for 125 consecutive patients who underwent laparoscopic segmental hepatectomy from January 2015 to May 2018 (68 in the ABT group versus 57 in the PM group). We compared patients' characteristics and intra- and postoperative short-term outcomes between the groups. Results: The 2 groups were well matched regarding patients' clinical characteristics, types of liver resection, operative time, and histopathological findings (P > .05). Median blood loss was significantly lower in the PM group versus the ABT group (200 mL versus 750 mL, respectively; P < .01), and overall complication rates were similar (n = 12 [17%] versus n = 9 [16%], respectively; P > .05). The ABT group had significantly lower mean levels of total bilirubin, indirect bilirubin, aspartate transaminase, and alanine aminotransferase on postoperative days 1 and 3 (P < .05). The ABT group had a shorter hospital stay compared with the PM group (5.8 days versus 7.7 days, respectively; P < .05) and lower hospitalization costs (55,400 ± 15,400 versus 667,000 ± 21,600 CN dollars, respectively; P < .05). Conclusions: Compared with Pringle's maneuver, laparoscopic hepatectomy with ABT promoted early recovery of liver function and reduced hospitalization costs in select patients with benign hepatic neoplasms.

Keywords: Pringle maneuver; autologous blood transfusion; autologous salvaged blood; laparoscopic hepatectomy.

MeSH terms

  • Adult
  • Aged
  • Alanine Transaminase / blood
  • Aspartate Aminotransferases / blood
  • Bilirubin / blood
  • Blood Loss, Surgical / statistics & numerical data
  • Blood Transfusion, Autologous*
  • Female
  • Hepatectomy / methods*
  • Humans
  • Laparoscopy / methods*
  • Length of Stay / statistics & numerical data
  • Liver Neoplasms / surgery*
  • Male
  • Middle Aged
  • Operative Time
  • Postoperative Period
  • Retrospective Studies

Substances

  • Aspartate Aminotransferases
  • Alanine Transaminase
  • Bilirubin