Digestive Diseases and Sciences

, Volume 56, Issue 5, pp 1548–1556 | Cite as

Pringle Maneuver Deteriorates Gut Barrier Dysfunction Induced by Extended-Liver Radiofrequency Ablation

  • Petros Ypsilantis
  • Maria Lambropoulou
  • Anastasia Grapsa
  • Ioannis Tentes
  • Christina Tsigalou
  • Maria Panopoulou
  • Constantinos Simopoulos
Original Article



Large volume radiofrequency ablation (RFA) of the liver disrupts intestinal mucosa barrier with subsequent bacterial translocation.


To investigate the effect of the Pringle maneuver applied concurrently with extended liver RFA on gut barrier integrity and bacterial translocation.

Materials and Methods

Rats were subjected to 30% liver RFA following laparotomy (group RFA), RFA plus 30 min Pringle (group RFA + P), Pringle (group P) or sham operation (group S). Intestinal tissue specimens were excised for histopathological examination and assessment of mucosal morphometry, apoptotic activity, mitotic activity and oxidative state. Tissue specimens were collected from the mesenteric lymph nodes, non-ablated liver parenchyma, kidneys and lungs for bacterial culture. Blood samples were collected from the portal and systemic circulation for endotoxin level measurement.


In group RFA + P, intestinal histopathologic lesions, mucosal atrophy and crypt cell apoptosis were more prominent compared to group RFA. Mitotic activity was suppressed. Oxidative stress was equally induced in all experimental groups. The incidence of positive bacterial cultures, bacterial counts and endotoxin levels were higher in group RFA + P compared to the other groups.


The application of the Pringle maneuver concurrently with extended liver RFA aggravates gut barrier dysfunction with more aggressive translocation of endotoxins and intestinal bacteria.


Radiofrequency ablation Pringle Gut barrier Bacterial translocation 


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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Petros Ypsilantis
    • 1
  • Maria Lambropoulou
    • 2
  • Anastasia Grapsa
    • 3
  • Ioannis Tentes
    • 4
  • Christina Tsigalou
    • 5
  • Maria Panopoulou
    • 3
  • Constantinos Simopoulos
    • 1
  1. 1.Laboratory of Experimental Surgery and Surgical Research, School of MedicineDemocritus University of ThraceAlexandroupolisGreece
  2. 2.Laboratory of Histology and Embryology, School of MedicineDemocritus University of ThraceAlexandroupolisGreece
  3. 3.Laboratory of Microbiology, School of MedicineDemocritus University of ThraceAlexandroupolisGreece
  4. 4.Laboratory of Biochemistry, School of MedicineDemocritus University of ThraceAlexandroupolisGreece
  5. 5.Laboratory of BiochemistryUniversity General Hospital of AlexandroupolisAlexandroupolisGreece

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