The effects of urinary trypsin inhibitor on liver function and inflammatory factors in patients undergoing hepatectomy: a prospective, randomized, controlled clinical study

BackgroundThe inhibition of inflammation exerts benefits following massive hepatectomy in animals but not in the clinic. The aim of this study was to investigate the effectiveness and mechanism of ulinastatin on liver function and outcomes following hepatectomy.MethodsOne hundred seventy-six patients undergoing hepatectomy were randomized into the treatment group (n = 86) and the control group (n = 90), receiving ulinastatin 150,000 U twice daily for 3 days and saline vehicle, respectively. Liver function, coagulation, thrombokinase, lymphocyte subsets CD4 and CD8, C-reactive protein, inducible nitric oxide synthase, and cytokines were measured. Clinical outcomes were also evaluated.ResultsSerum alanine transaminase, aspartate transferase, inducible nitric oxide synthase, and tumor necrosis factor–α levels were significantly lower after ulinastatin treatment, and the response of bilirubin was delayed. The benefits of ulinastatin were shown mainly in major hepatectomy earlier after surgery. The treatment significantly reduced hospital length of stay and recovery-related cost.ConclusionsUlinastatin protects liver function and improves clinical outcomes, possibly via the inhibition of inflammation and oxidation at an earlier stage following major hepatectomy.