Preoperative Fasting Improves Survival After 90% Hepatectomy

Sarac, Timur P.; Sax, Harry C.; Doerr, R.; Yuksel, Umit; Pulli, Ronald S.; Caruana, Joseph

doi:10.1001/archsurg.1994.01420310061010

Cited by 24 publications

(13 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Dextrose effects regeneration by increasing the secretion of hepatotrophic insulin (29). Similarly in Gaub and Iverson's feeding rats model study, survive of the rats was increased to 80% with postoperative glucose solution (32).…”

Section: Discussionmentioning

confidence: 96%

See 1 more Smart Citation

The Outcome of Major Hepatectomies Following Different Durations of Portal Vein Ligation in Rats

et al. 2005

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 96%

“…It has been known that vena portae carries hepatotrophic factors (Insulin, glucagon etc.) (15,(27)(28)(29)(30)(31)(32). Atrophy in ligated lobe and hypertrophy in opposite lobe have been observed in human and animals and this was called Atrophy/Hypertrophy complex (AHC) (14).…”

Section: Discussionmentioning

confidence: 99%

The Outcome of Major Hepatectomies Following Different Durations of Portal Vein Ligation in Rats

et al. 2005

View full text Add to dashboard Cite

“…Its induction and recovery times are very fast, and its depth can be adjusted easily and quickly 18 . It is considered to be the ideal anesthetic for studies of metabolism and toxicity due to its minimal systemic metabolism, the small effect it has on liver enzymes and the reduced potential risk of liver and kidney damage that arise from its use [18][19][20][21] ; however, isoflurane anesthesia has been used in a few studies of models of extended hepatectomy in murine rodents 8,[17][18][19] .…”

Section: Discussionmentioning

confidence: 99%

The effects of anesthetic regimen in 90% hepatectomy in rats

Kieling

Backes²,

Maurer³

et al. 2012

Acta Cir. Bras.

View full text Add to dashboard Cite

PURPOSE:To evaluate the influence of the anesthetic regimen on anesthetic recovery, survival, and blood glucose levels following a 90% partial hepatectomy in rats. METHODS:Thirty adult male Wistar rats were divided into two groups according to their anesthetic regimens: intraperitoneal ketamine and xylazine or inhaled isoflurane. In order to prevent hypoglycemia, glucose was administered intraperitoneally and glucose (20%) was added to the drinking water. RESULTS:Anesthetic recovery time was longer in the ketamine and xylazine group. The survival rate after 72 hours was lower (log rank=0.0001) in the ketamine and xylazine group (0.0%) than in the isoflurane group (26.7%). The blood glucose after six hours was lower (p=0.017) in the ketamine and xylazine group (63±31.7 mg/dL) than in the isoflurane group (98±21.2 mg/dL). The prolonged anesthesia recovery time associated with ketamine and xylazine decreased the survival rate and blood glucose levels after 90% hepatectomy. CONCLUSION:Isoflurane anesthesia reduced the recovery time and incidence of hypoglycemia and increased the survival rate in the early hours, providing a therapeutic window that is suitable for experimental studies.Key words: Liver Failure, Acute. Hepatectomy. Isoflurane. Ketamine. Xylazine. Ratos. RESUMO OBJETIVO:Avaliar a influência do regime anestésico sobre a recuperação anestésica, a sobrevida em 72 horas e a glicemia após hepatectomia parcial de 90% em ratos. MÉTODOS:Trinta ratos Wistar machos adultos foram distribuídos em dois grupos conforme o regime anestésico: combinação de ketamina e xilazina intraperitoneal ou isoflurano inalatório. Para prevenção de hipoglicemia foi administrada glicose intraperitoneal e adicionado glicose (20%) na água de beber. RESULTADOS:A recuperação anestésica no grupo ketamina e xilazina foi mais prolongada. Durante primeira hora após hepatectomia, nenhum rato anestesiado com ketamina e xilazina despertou. Todos do grupo isoflurano estavam ativos minutos após final da cirurgia. The effects of anesthetic regimen in 90% hepatectomy in ratsActa Cirúrgica Brasileira -Vol. 27 (10) 2012 -703 A sobrevida em 72 horas foi menor (Log rank=0,0001) no grupo ketamina e xilazina (0,0%) que no grupo isoflurano (26,7%). Glicemia em 6 horas do grupo ketamina e xilazina (63±31,7 mg/dL) foi menor (p=0,017) que no grupo isoflurano (98 ±21,2 mg/dL). Prolongado tempo de recuperação anestésica com ketamina e xilazina diminuiu sobrevida e glicemia após hepatectomia 90%.CONCLUSÃO: Anestesia com isoflurano reduziu tempo de recuperação e hipoglicemia, além de aumentar a sobrevida nas primeiras horas, possibilitando uma janela terapêutica adequada para estudos experimentais.

show abstract

“…In the immediate postoperative period after major hepatectomy, the portal bed in the remnant liver is drastically reduced for easy flow of the whole portal blood and produces portal congestion and hemodynamic instability [3][4][5]. Although there are some reports enumerating successful extended hepatic resections (80-90%) in rats pretreated by testosterone 1 month before the resection or in preoperatively fasted rats fed with 20% glucose solution in the postoperative period [6,7], the extended hepatic resection has been rarely studied in big animal models [8]. FK506 (FK), a hydrophobic neutral macrolide of Streptomyces tsukubaensis origin and the most potent immunosuppressant drug ever discovered, has been documented to possess a hepatotrophic effect after liver resections [9].…”

Section: Introductionmentioning

confidence: 99%

FK506 with Portal Decompression Exerts Beneficial Effects following Extended Hepatectomy in Dogs

Mitsumoto¹,

Dhar²,

Yu³

et al. 1999

Eur Surg Res

View full text Add to dashboard Cite

The present study was designed to elucidate the effectiveness of portal decompression and FK506 (FK) pretreatment in extended hepatectomy in dogs. In the first set of experiment the effect of portal decompression was evaluated in two groups of dogs which underwent extended hepatectomies (80%) with or without (control) a side-to-side portacaval shunt. The presence of the shunt significantly (p < 0.05) improved the 7-day survival of the animals (57.1%) when compared with those of the control group (28.6%) and eventually the portal pressure was significantly lower and mean arterial pressure was significantly higher in the shunt group (p < 0.05). Moreover, the animals with lower portal pressure (≤220 mm of saline) had a significantly improved 7-day survival rate than those with higher portal pressure (p < 0.001). To evaluate the role of FK pretreatment in extended hepatectomy, a more severe model of 90% hepatectomy was used in four different groups: portacaval shunt, shunt and FK pretreatment, FK pretreatment, and hepatectomy only (control). Although the shunt improved the survival rate in the 80% hepatectomy model, neither shunt (8.3%) nor FK pretreatment (0%) independently improved the survival of the animals when the hepatectomy was extended to 90%. FK pretreatment significantly improved the survival (33.3%, p < 0.05) and hepatic functions of the animals only in the presence of a shunt. Also hepatic microcirculation measured with a laser Doppler flowmeter was significantly better in the remnant liver of all treated groups than in the control group (p < 0.01). In conclusion, extended hepatectomy (90%) could be performed in otherwise normal liver after FK pretreatment and a side-to-side portacaval shunt, which improve the regenerative response in a stable hemodynamic animal.

show abstract

Preoperative Fasting Improves Survival After 90% Hepatectomy

Abstract: Fasting before hepatectomy shifts energy utilization to fat oxidation and gluconeogenesis, which appears to ameliorate liver failure after hepatectomy in this severe model of hepatic resection.

Cited by 24 publications

References 16 publications

The Outcome of Major Hepatectomies Following Different Durations of Portal Vein Ligation in Rats

The Outcome of Major Hepatectomies Following Different Durations of Portal Vein Ligation in Rats

The effects of anesthetic regimen in 90% hepatectomy in rats

FK506 with Portal Decompression Exerts Beneficial Effects following Extended Hepatectomy in Dogs

Contact Info

Product

Resources

About