کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
4296114 1612342 2006 9 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Ischemic Preconditioning for Major Liver Resection under Vascular Exclusion of the Liver Preserving the Caval Flow: A Randomized Prospective Study
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی عمل جراحی
پیش نمایش صفحه اول مقاله
Ischemic Preconditioning for Major Liver Resection under Vascular Exclusion of the Liver Preserving the Caval Flow: A Randomized Prospective Study
چکیده انگلیسی

BackgroundTwo randomized prospective studies suggested that ischemic preconditioning (IP) protects the human liver against ischemia-reperfusion injury after hepatectomy performed under continuous clamping of the portal triad. The primary goal of this study was to determine whether IP protects the human liver against ischemia-reperfusion injury after hepatectomy under continuous vascular exclusion with preservation of the caval flow.Study designSixty patients were randomly divided into two groups: with (n = 30; preconditioning group) and without (n = 30; control group) IP (10 minutes of portal triad clamping and 10 minutes of reperfusion) before major hepatectomy under vascular exclusion of the liver preserving the caval flow. Serum concentrations of aspartate transferase, alanine transferase, glutathione-S-transferase, and bilirubin and prothrombin time were regularly determined until discharge and at 1 month. Morbidity and mortality were determined in both groups.ResultsPeak postoperative concentrations of aspartate transferase were similar in the groups with and without IP (851 ± 1,733 IU/L and 427 ± 166 IU/L respectively, p = 0.2). A similar trend toward a higher peak concentration of alanine transferase and glutathione-S-transferase was indeed observed in the preconditioning group compared with the control group. Morbidity and mortality rates and lengths of ICU and hospitalization stays were similar in both groups.ConclusionsIP does not improve liver tolerance to ischemia-reperfusion after hepatectomy under vascular exclusion of the liver with preservation of the caval flow. This maneuver does not improve postoperative liver function and does not affect morbidity or mortality rates. The clinical use of IP through 10 minutes of warm ischemia in this technique of hepatectomy is not currently recommended.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Journal of the American College of Surgeons - Volume 202, Issue 2, February 2006, Pages 203–211
نویسندگان
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