The role of growth hormone, somatostatin and glucagon in hepatic resection.
OBJECTIVE
The aim of this study was to clarify the roles of growth hormone, somatostatin, and glucagon in vital reactions against surgical stress as well as in hepatic regeneration.


METHODS
Eleven consecutive patients, who underwent hepatic resection, were included in this study. Changes in intrinsic hormones, specifically growth hormone, somatostatin, and glucagon, were investigated. Furthermore, a comparison was made between major (more than 2 segments) and minor (less than 1 segment) hepatectomies.


RESULTS
Growth hormone was observed to increase four-fold during hepatectomy and thereafter remained at relatively high levels. Somatostatin reached its lowest level on postoperative day 1 and then returned to near the preoperative level on postoperative day 7, while glucagon gradually increased and reached a peak around postoperative day 3. The concentrations of both somatostatin and glucagon in the portal vein were higher than those in the peripheral vein. No significant differences between major and minor hepatectomies were found throughout the perioperative course.


CONCLUSIONS
Growth hormone is considered to be a sensitive parameter in terms of surgical stress and can also act as a trigger as well as a promoter of hepatic regeneration, while a dissociation between somatostatin and glucagon in the early postoperative period indicates the promotion of hepatic regeneration. Furthermore, portal blood, which contains higher concentrations of these substances, plays an important role in regulating hepatic regeneration. However, the absence of a correlation between the extent of the hepatectomy and these parameters suggests that some other, as yet unidentified mechanism, may also be related to the regulation of hepatic regeneration.
Shimada
M
M
Second Department of Surgery, Faculty of Medicine, Kyushu University, Japan.
Matsumata
T
T
Yamamoto
K
K
Taketomi
A
A
Shirabe
K
K
Takenaka
K
K
Sugimachi
K
K
D000368:Aged; D005260:Female; D005934:Glucagon / Q000097:blood*; D013006:Growth Hormone / Q000097:blood*; D006498:Hepatectomy / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D013004:Somatostatin / Q000097:blood*; D013312:Stress, Physiological / Q000097:blood / Q000209:etiology
D013004:Somatostatin; D013006:Growth Hormone; D005934:Glucagon