Pringle's maneuver lasting 322min

Up to now, the reported limit of 'continuous' Pringle's maneuver during hep atectomy has not exceeded 127min. Here we used 'intermittent' clamping to i ncrease the cumulative time of safe ischemia. A 49 year-old man who had und ergone jejunal resection because of leiomyosarcoma was referred with 18 hep atic metastases. Using 'intermittent' Pringle's maneuver, enucleation of th e entire tumor was performed. The cumulative ischemic time of the liver was 322min, but post-operative serum level total bilirubin remained normal. Th e patient was discharged on day 24 without any complications, remaining wel l for up to 5 months after surgery. The present case shows that the safe up per limit of cumulative hepatic ischemia can be extended to 322min.