Differential Impact of Pringle and Portal Vein Occlusion on Myocardial Injury After Non-Cardiac Surgeries.

Differential Impact of Pringle Occlusion vs. Portal Vein Occlusion-Induced Liver Ischaemia-Reperfusion Injury on Myocardial Injury Following Noncardiac Surgeries.

Status

Completed

Phases

Unknown

Study type

Observational

Source

ClinicalTrials.gov

Registry ID

NCT06895798

Enrollment

1286

Registered

2025-03-26

Start date

2025-03-07

Completion date

2026-01-15

Last updated

2026-06-12

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Ischemia Reperfusion Injury, Myocardial Injury After Non-Cardiac Surgery

Keywords

liver ischemia reperfusion injury, Myocardial Injury After Non-Cardiac Surgery, Major Hepato-Biliary Surgery, Pringle occlusion, Portal vein occlusion

Brief summary

This study aims to investigate the impact of hepatic ischemia-reperfusion injury (HIRI) on the incidence of myocardial injury after non-cardiac surgery (MINS) and explore the potential underlying mechanisms. A bidirectional cohort study will be conducted, enrolling patients scheduled for major hepato-biliary surgery. Clinical data, perioperative parameters, and postoperative follow-up data will be systematically collected. The incidence of MINS between patients undergoing Pringle occlusion and portal vein occlusion will be compared, and a multivariate analysis will be performed to identify independent risk factors for MINS, providing a basis for early recognition and prevention of MINS.

Detailed description

This observational cohort study consists of both retrospective and prospective components. The study population includes patients undergoing major hepato-biliary surgery (defined as operative time \> 4 hours and postoperative ICU admission) who are either ≥ 65 years old or ≥ 45 years old with cardiovascular risk factors (especially known cardiovascular disease). The exposed group (Pringle group) consists of patients who experience liver ischemia-reperfusion injury due to Pringle occlusion during surgery. The control group (Portal vein group) consists of patients who experience liver ischemia-reperfusion injury due to Portal vein occlusion. The primary outcome is the incidence of MINS (myocardial injury after non-cardiac surgery) within 3 days postoperatively. Secondary outcomes include postoperative length of hospital stay, incidence of complications within 30 days postoperatively, and 1-year survival rate. Finally, liver and blood samples will be collected from a subset of patients in the prospective LIRI group for pathophysiological mechanism investigation.

Interventions

None listed

Study design

Observational model

COHORT

Time perspective

OTHER

Eligibility

Sex/Gender

ALL

Age

45 Years to 85 Years

Healthy volunteers

Inclusion criteria

* Age ≥ 65 years, or ≥ 45 years with cardiovascular risk factors (especially known cardiovascular disease). * Undergoing elective major hepatopancreatobiliary surgery under general anesthesia. * ASA physical status II-III. * Provide written informed consent to participate in the study (applicable to the prospective cohort).

Exclusion criteria

* Emergency surgery * Preoperative diagnosis of myocardial infarction or unstable angina * Severe hepatic insufficiency (Child-Pugh class C) * Concomitant severe organ dysfunction (e.g., renal failure, respiratory failure) * Concomitant active infectious disease

Design outcomes

Primary

Measure	Time frame	Description
Myocardial injury after non-cardiac surgery (MINS)	Within 3 days after surgery	MINS, a high-sensitivity troponin T (hs-cTnT) of 20 to \<65 ng/L with an absolute change of at least 5 ng/L

Countries

China

Outcome results