Suc B, Panis Y, Belghiti J, Fékété F
Department of Digestive Surgery, Hôpital Beaujon, Clichy, France.
Br J Surg. 1992 Jan;79(1):39-42. doi: 10.1002/bjs.1800790113.
The aim of this study was to describe biochemical and liver function test changes after hepatectomy in 33 patients with the following characteristics: absence of underlying liver disease, no blood or plasma transfusion during the perioperative period, uneventful postoperative course. Resection with a temporary pedicle inflow occlusion (10-45 min) consisted of unisegmentectomy or less in 15 patients and bisegmentectomy or more in 18. Blood tests showed: a correlation between aminotransferase rise and duration of ischaemia, and a fall in prothrombin time and factor V levels correlating with the weight of resected specimen at day 1; a moderate gamma-glutamyl transpeptidase and alkaline phosphatase elevation and a rise in fibrinogen level correlating with the extent of resection at day 7. Changes in haemoglobin level, white cell count, platelet count, prothrombin time, factor V level and serum bilirubin level tended to return to preoperative levels by day 7. For gamma-glutamyl transpeptidase and alkaline phosphatase, increased levels persisted for 8-12 weeks after resection. These results, in this selected group of patients, allow a description of the 'natural history' of hepatectomy. The knowledge of these 'natural' changes may contribute to the early detection of postoperative complications.
本研究旨在描述33例具有以下特征患者肝切除术后的生化及肝功能检查变化：无潜在肝脏疾病，围手术期未输血或血浆，术后病程平稳。采用临时肝蒂血流阻断（10 - 45分钟）进行肝切除，其中15例患者为单肝段或更少肝段切除，18例患者为双肝段或更多肝段切除。血液检查显示：转氨酶升高与缺血持续时间相关，术后第1天凝血酶原时间和V因子水平下降与切除标本重量相关；术后第7天，γ-谷氨酰转肽酶和碱性磷酸酶适度升高，纤维蛋白原水平升高与切除范围相关。血红蛋白水平、白细胞计数、血小板计数、凝血酶原时间、V因子水平和血清胆红素水平的变化在术后第7天趋于恢复至术前水平。γ-谷氨酰转肽酶和碱性磷酸酶水平在切除术后8 - 12周持续升高。在这组特定患者中，这些结果有助于描述肝切除的“自然病程”。了解这些“自然”变化可能有助于早期发现术后并发症。
