Pringle manoeuvre

The Pringle maneuver is a surgical maneuver used in some abdominal operations. A large atraumatic hemostat is used to clamp the hepatoduodenal ligament (free border of the lesser omentum) interrupting the flow of blood through the hepatic artery and the portal vein and thus helping to control bleeding from the liver. More commonly, in the absence of soft clamp, manual compression of the hepatoduodenal ligament is performed.

Should bleeding continue, it is likely that the inferior vena cava or the hepatic vein were also traumatised.[1] If bleeding continues, a variation in arterial blood flow may be present.

It was developed by James Hogarth Pringle, a graduate of medicine at the University of Edinburgh Medical School.

The Pringle manoeuvre is very often used during liver surgery to minimize blood loss; however it can directly lead to reperfusion phenomenon in the liver. The Pringle manoeuvre is applied during closure of a vena cava injury when an atriocaval shunt is placed.

References

Monkhouse, Stanley. Master Medicine: Clinical Anatomy (2nd ed.). ISBN 9780443102905. Retrieved 20 December 2016.

Medical and Surgical procedures involving the digestive system

Digestive tract

Upper GI tract

SGs / Esophagus	Esophagectomy Heller myotomy Sialography Impedance–pH monitoring Esophageal pH monitoring Esophageal motility study
Stomach	Bariatric surgery Adjustable gastric band Endoscopic sleeve gastroplasty Gastric bypass surgery Sleeve gastrectomy Vertical banded gastroplasty surgery Collis gastroplasty Gastrectomy Billroth I Billroth II Roux-en-Y Gastroenterostomy Gastropexy Gastrostomy Percutaneous endoscopic gastrostomy Esophagogastric dissociation Hill repair Nissen fundoplication Pyloromyotomy Schilling test
Medical imaging	Endoscopy: Esophagogastroduodenoscopy Barium swallow Upper gastrointestinal series

Lower GI tract

Small bowel	Bariatric surgery Duodenal switch Jejunoileal bypass Bowel resection Ileostomy Intestine transplantation Jejunostomy Partial ileal bypass surgery Strictureplasty
Large bowel	Appendicectomy Colectomy Colonic polypectomy Colostomy Hartmann's operation
Rectum	Abdominoperineal resection / Miles operation Lower anterior resection Total mesorectal excision
Anal canal	Anal sphincterotomy Anorectal manometry Lateral internal sphincterotomy Rubber band ligation Transanal hemorrhoidal dearterialization
Medical imaging	Endoscopy: Colonoscopy Anoscopy Capsule endoscopy Enteroscopy Proctoscopy Sigmoidoscopy Abdominal ultrasonography Defecography Double-contrast barium enema Endoanal ultrasound Enteroclysis Lower gastrointestinal series Small-bowel follow-through Transrectal ultrasonography Virtual colonoscopy
Stool tests	Fecal fat test Fecal pH test Stool guaiac test

Accessory

Liver	Artificial extracorporeal liver support Bioartificial liver devices Liver dialysis Hepatectomy Liver biopsy Liver transplantation Portal hypertension Transjugular intrahepatic portosystemic shunt [TIPS] Distal splenorenal shunt procedure
Gallbladder, bile duct	Cholecystectomy Cholecystostomy ERCP Hepatoportoenterostomy Medical imaging: Cholangiography IV MRCP PTC Cholecystography Cholescintigraphy
Pancreas	Frey's procedure Pancreas transplantation Pancreatectomy Pancreaticoduodenectomy Puestow procedure

Abdominopelvic

Peritoneum	Diagnostic peritoneal lavage Intraperitoneal injection Laparoscopy Omentopexy Paracentesis Peritoneal dialysis
Hernia	Hernia repair: Inguinal hernia surgery Femoral hernia repair

Other

CPRs

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