Pringle manoeuvre
Pringle manoeuvre is a surgical technique used in abdominal surgery, specifically in liver surgery, to control bleeding. Named after the Scottish surgeon James Hogarth Pringle, who first described it in 1908, the manoeuvre involves clamping the hepatoduodenal ligament to temporarily stop the flow of blood to the liver.
Procedure
The Pringle manoeuvre is performed by placing a vascular clamp or a tourniquet around the hepatoduodenal ligament, which contains the portal vein, hepatic artery, and common bile duct. This effectively halts the flow of blood to and from the liver, reducing the risk of excessive bleeding during liver surgery.
Applications
The Pringle manoeuvre is commonly used in liver resections and liver transplant surgeries. It is also used in trauma surgery when there is significant liver injury.
Risks and Complications
While the Pringle manoeuvre is effective in controlling bleeding, it also poses risks. Prolonged clamping can lead to liver ischemia, which can cause liver damage. Other potential complications include bile duct injury and postoperative liver failure.
Alternatives
Alternatives to the Pringle manoeuvre include the selective clamping of the hepatic artery and portal vein, and the use of the Tourniquet technique.
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Contributors: Prab R. Tumpati, MD