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

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.

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