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Invited Critique
July 1, 2006

Safety of Prolonged Intermittent Pringle Maneuver During Hepatic Resection—Invited Critique

Arch Surg. 2006;141(7):654. doi:10.1001/archsurg.141.7.654

In this issue of the ARCHIVES, Ishizaki et al1 report a remarkable series of 34 complex liver resections (see their Table 1) for a variety of metastatic and primary malignant neoplasms (1 case involved benign disease). The crux of this retrospective review was to demonstrate not the safety and efficacy of their technique of liver resection but its superiority. They use the IPM (15 minutes of occlusion followed by 5 minutes of reperfusion) throughout the hepatic resection. They note that, while this technique is used in Asia, it is not widely accepted in the West primarily because of concerns about excessive blood loss.