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Bleeding can obstruct surgical field visibility and increase conversion rates and risk of common bile duct injury. The Pringle maneuver is a simple occlusion approach that could limit blood flow from the hepatic pedicle, thus controlling bleeding to provide a clear surgical field to reduce conversion rate. In this study, we aimed to investigate the feasibility, effectiveness and safety of hepatic pedicle occlusion with the Pringle maneuver during difficult LC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>From 2011 to 2015, LC with hepatic pedicle occlusion by the Pringle maneuver was performed in 67 patients (Pringle group). Another group of 67 cases with matched clinical parameters where LC was performed without the Pringle maneuver (non\u2010Pringle group) was retrieved from a database to serve as the control group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The Pringle group had a significantly lower conversion rate (1.49% vs. 11.9%; <jats:italic>P<\/jats:italic>\u2009=\u20090.038), less blood loss (37.5\u2009\u00b1\u200924.1\u00a0mL vs. 94.5\u2009\u00b1\u200967.8\u00a0mL; <jats:italic>P<\/jats:italic>\u2009=\u20090.002), shorter postoperative hospitalization (2.5\u2009\u00b1\u20091.4\u00a0days vs. 3.5\u2009\u00b1\u20092.5\u00a0days; <jats:italic>P<\/jats:italic>\u2009=\u20090.005), and lower cost ($1343\u2009\u00b1\u2009$751 USD vs. $1674\u2009\u00b1\u2009$609 USD; <jats:italic>P<\/jats:italic>\u2009=\u20090.024) than non\u2010Pringle group. There was one case each of bile duct injury and readmission within 30\u00a0days because of bile leakage in the non\u2010Pringle group, but none in the Pringle group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Hepatic pedicle occlusion could provide a clear surgical field and enable the recognition of structures during LC. The Pringle maneuver offers a feasible and safe approach to lower conversion rates in difficult LC.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-018-4770-z","type":"journal-article","created":{"date-parts":[[2018,9,28]],"date-time":"2018-09-28T22:29:08Z","timestamp":1538173748000},"page":"207-213","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Hepatic Pedicle Occlusion with the Pringle Maneuver During Difficult Laparoscopic Cholecystectomy Reduces the Conversion Rate"],"prefix":"10.1002","volume":"43","author":[{"given":"Rongce","family":"Zhao","sequence":"first","affiliation":[{"name":"Department of Liver Surgery and Liver Transplantation Center, West China Hospital Sichuan University No. 37 Guoxuexiang 610041 Chengdu Sichuan Province China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fei","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Liver Surgery and Liver Transplantation Center, West China Hospital Sichuan University No. 37 Guoxuexiang 610041 Chengdu Sichuan Province China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chenyang","family":"Jia","sequence":"additional","affiliation":[{"name":"Department of Liver Surgery and Liver Transplantation Center, West China Hospital Sichuan University No. 37 Guoxuexiang 610041 Chengdu Sichuan Province China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kefei","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Liver Surgery and Liver Transplantation Center, West China Hospital Sichuan University No. 37 Guoxuexiang 610041 Chengdu Sichuan Province China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yonggang","family":"Wei","sequence":"additional","affiliation":[{"name":"Department of Liver Surgery and Liver Transplantation Center, West China Hospital Sichuan University No. 37 Guoxuexiang 610041 Chengdu Sichuan Province China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junhua","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of General Surgery Chengdu First People\u2019s Hospital Chengdu China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bo","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Liver Surgery and Liver Transplantation Center, West China Hospital Sichuan University No. 37 Guoxuexiang 610041 Chengdu Sichuan Province 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