Plasma bilirubin correlations in non-obstructive cholestasis after partial hepatectomy

Chiarla, Carlo; Giovannini, Ivo; Giuliante, Felice; Vellone, Maria; Ardito, Francesco; Masi, Antonio; Nuzzo, Gennaro

doi:10.1515/cclm.2008.321

Cited by 8 publications

(5 citation statements)

References 12 publications

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“…IR injury may arise from either portal triad clamping or total vascular exclusion, . Hepatic IR injury, by triggering the activation of inflammatory pathways leading to exaggerated systemic inflammation and parenchymal disruption, is associated with pathological conditions ranging from abnormalities in blood chemistry to postoperative liver failure, cholestasis and death, . From an oncological standpoint, liver IR injury might promote tumour proliferation.…”

Section: Introductionmentioning

confidence: 99%

Systematic review and meta-analysis of the effect of perioperative steroids on ischaemia–reperfusion injury and surgical stress response in patients undergoing liver resection

Orci

Toso

Mentha

et al. 2013

British Journal of Surgery

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Section: Introductionmentioning

confidence: 99%

Systematic review and meta-analysis of the effect of perioperative steroids on ischaemia–reperfusion injury and surgical stress response in patients undergoing liver resection

Orci

Toso

Mentha

et al. 2013

British Journal of Surgery

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“…Furthermore, serum total bilirubin values were significantly lower in the ulinastatin group. The increase in serum bilirubin after liver resection is likely related to parenchymal ischemia or inflammation [11]. This finding implied that it was difficult to judge that ulinastatin directly induced liver damage by liver manipulation, but ulinastatin could affect the increase of secondary metabolic or inflammatory AST and ALT after the liver resection.…”

Section: Discussionmentioning

confidence: 99%

Urinary trypsin inhibitor attenuates liver enzyme elevation after liver resection

Chang-hyun

Lee

et al. 2012

Korean J Anesthesiol

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BackgroundUrinary trypsin inhibitors (UTI) have been widely used for the treatment of diseases including disseminated intravascular coagulation, shock, and pancreatitis. Since UTI synthesis is likely to be reduced in patients who have undergone liver resection, the incidence of inflammatory reactions may be increasing accordingly. For such patients, the liver enzyme increases after the operation can reflect liver damage. The purpose of this study was to examine if ulinastatin can inhibit liver enzyme increases after liver resection.MethodsAfter receiving Institutional Review Board approval, a retrospective chart review was performed on 201 patients who underwent hepatic resection from 2006 to 2010. We divided the records into the control (n = 69) and ulinastatin (n = 132) groups according to the use of intraoperative ulinastatin and compared the preoperative and postoperative laboratory test results. The number of patients who had > 400 U/L elevation of aspartate transaminase (AST) level after surgery was compared between the 2 groups.ResultsThe mean AST, alanine transaminase (ALT), and total bilirubin levels after liver resection were significantly lower in the ulinastatin group than in the control group. The number of patients who showed an AST > 400 U/L after liver resection was significantly higher in the control group (odds ratio = 3.02).ConclusionsUlinastatin attenuates the elevation of hepatic enzymes and bilirubin after liver resection.

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“…Prior studies have investigated patterns of biochemical markers following hepatic resection, but many of these analyses were conducted before the twenty-first century [2,4,5] or had small sample sizes (largest series, n = 288; [1,[6][7][8]). Although some existing studies have focused on specific patient populations or indications for surgery [3,7,9], we are aware of no contemporary studies that directly compare enzyme kinetics based on pre-existing liver impairment.…”

Section: Introductionmentioning

confidence: 99%

Demystifying post-hepatectomy enzyme kinetics for the surgical learner: an analysis of 989 major hepatectomies

et al. 2022

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Few resources exist for surgical learners in interpreting trends in biochemical markers following major hepatic resections. Methods Adult patients who underwent major hepatectomy between 2010 and 2020 were included from twelve international centers. Patients were classified as healthy donor, benign disease, non-alcoholic fatty liver disease, prior chemotherapy, or cirrhosis. Median values of total bilirubin and INR were plotted against time and compared across groups using the Kruskal-Wallis test. Results Across groups (n = 989), median total bilirubin and INR were observed to peak on postoperative day (POD) 1. While the healthy donor group (n = 156) had the highest median total bilirubin on POD1 (2.4, IQR: 1.7-3.3), they had the fastest rate of recovery such that by POD5, values were lower than those of the NAFLD (n = 26), chemotherapy (n = 92), and cirrhosis (n = 668) groups. Donor patients also had the highest POD1 INR (median 1.5, IQR: 1.4-1.7), while patients with NAFLD had the highest POD5 INR levels (1.2, IQR: 1.1, 1.4). The lowest POD1 total bilirubin and INR levels were observed in the cirrhosis group (1.5, 1.3, respectively). Statistically significant differences in total bilirubin and INR were observed across groups at all timepoints (p < 0.05). Conclusions We observed the healthy donor patients to have the highest postoperative enzyme peaks, but most rapid rate of return to normal. This illustration of the postoperative kinetics of biochemical liver function tests may serve as a useful reference for clinical learners monitoring patients in the first week following major hepatectomy.

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Plasma bilirubin correlations in non-obstructive cholestasis after partial hepatectomy

Cited by 8 publications

References 12 publications

Systematic review and meta-analysis of the effect of perioperative steroids on ischaemia–reperfusion injury and surgical stress response in patients undergoing liver resection

Systematic review and meta-analysis of the effect of perioperative steroids on ischaemia–reperfusion injury and surgical stress response in patients undergoing liver resection

Urinary trypsin inhibitor attenuates liver enzyme elevation after liver resection

Demystifying post-hepatectomy enzyme kinetics for the surgical learner: an analysis of 989 major hepatectomies

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