World Journal of Surgery

, Volume 34, Issue 9, pp 2162–2167 | Cite as

Surgical Treatment of Giant Liver Hemangiomas: Enucleation with Continuous Occlusion of Hepatic Artery Proper and Intermittent Pringle Maneuver

  • Feng Xia
  • Wan-Yee Lau
  • Cheng Qian
  • Shuguang Wang
  • Kuansheng Ma
  • Ping BieEmail author



The present study was designed to investigate the efficacy and safety of continuous occlusion of the hepatic artery proper combined with intermittent use of the Pringle maneuver for reduction of blood loss during enucleation of giant liver hemangiomas.


A retrospective study was performed on 115 patients who underwent enucleation of giant liver hemangiomas with or without continuous occlusion of the hepatic artery proper at a tertiary care university hospital. The characteristics of patients and perioperative parameters including intraoperative blood loss, the degree of ischemia–reperfusion injury, the incidence and severity of postoperative complications, and the length of hospital stay were summarized and compared in the two groups.


Seventy-three and 42 patients underwent enucleation of hepatic hemangiomas with and without continuous occlusion of the hepatic artery proper, respectively. The Pringle maneuver was routinely used in all patients in cycles of 15/5 min of clamp/unclamp times. Patient characteristics were comparable between the two groups. Intraoperative blood loss and blood transfusion in the continuous occlusion group were significantly lower than in the non-occlusion group (P < 0.001 and P = 0.012, respectively). In a comparison of the two groups, there were no significant differences in the changes of the perioperative serum aspartate transaminase and total bilirubin levels (P = 0.086, P = 0.829, respectively), and in the postoperative hospital stay and surgical complications according to Clavien’s classification (P = 0.378, P = 0.227, respectively).


Continuous occlusion of the hepatic artery proper when added to intermittent use of the Pringle maneuver significantly reduced intraoperative blood loss when compared with intermittent Pringle maneuver alone. Enucleation of giant hepatic hemangiomas using continuous occlusion of the hepatic artery proper in addition to intermittent application of the Pringle maneuver for up to 1 h was safe.


Hepatic Artery Hemangioma Pringle Maneuver Postoperative Serum Hepatic Hemangioma 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



This work was supported by National S&T Major Project (No. 2008ZX10002-026). The authors are grateful to our research assistants Zhongfang Jie and Hua Li for their help with data collection and statistical analyses.


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Copyright information

© Société Internationale de Chirurgie 2010

Authors and Affiliations

  • Feng Xia
    • 1
  • Wan-Yee Lau
    • 2
  • Cheng Qian
    • 3
  • Shuguang Wang
    • 1
  • Kuansheng Ma
    • 1
  • Ping Bie
    • 1
    Email author
  1. 1.Institute of Hepatobiliary Surgery, Southwest HospitalThird Military Medical UniversityChongqingChina
  2. 2.Faculty of MedicineThe Chinese University of Hong KongShatinChina
  3. 3.Department of PathologyThird Military Medical UniversityChongqingChina

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