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KMID : 0870419980020010033
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Korean Journal of Hepato-Biliary-Pancreatic Surgery
1998 Volume.2 No. 1 p.33 ~ p.37
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Attenuated Ischemic Injury to Human Liver during Hepatectomy by Simple In Situ Hypothermia
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Joo Dae-Hyun
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Abstract
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Background/Aims: To assess the preventive effect of simple in situ cooling on ischemic injury in human livers.
Methods: The study consisted of 22 patients who were to undergo liver resection (right lobectomy, n=6, left lobectomy, n=3, posterior segmentectomy, n=1, and extended cholecystectomy, n=1, in each group). All but 2 had normal remnant livers and all patients were randomised to undergo either warm ischemia or in situ cooling (n=11 in each group).
Results: The mean (SD) occlusion time was 53.7 (5.8) minutes for the warm ischemia group and 52.7(3.1) for the in situ cooling group. After in situ cooling, the state of the liver as indicated by serum alanine aminotransferase activity (ALT) and prothrombin time had improved substantially. Mean (SD) ALT activity was 483 (192) U/L in the warm ischemia group compared with 288 (157) in the in situ cooling group (p<0.02) on the first postoperative day. The respective figures for prothrombin time (%) were 58(23) compared with 77 (13), (p < 0.05).
Conclusion: In situ cooling lessened the amount of ischemic damage done to the liver during hepatectomy compared to treatment with that of warm ischemia.
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KEYWORD
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Simple in situ cooling, Ischemic injury
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