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

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.

Eligibility

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

Conditions4

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