Hyperactive cytokine response after partial hepatectomy in patients with biliary obstruction.
The relation of interleukin-6 (IL-6) levels in serum to the postoperative complications was assessed in 50 patients following an extensive hepatectomy. In addition, the postoperative levels of IL-6, tumor necrosis factor-a, and interleukin-1beta in peritoneal exudative fluid were determined in 22 patients. The patients with preoperative biliary obstruction showed a higher incidence of postoperative infection compared to those without (44 vs. 12%, p = 0.043). The postoperative serum IL-6 levels on day 1 were significantly higher in patients with postoperative infection than in those without (p<0.01). Biliary obstruction and intraoperative blood loss contributed to the increase in the serum IL-6 levels in a multiple regression analysis (p = 0.01 and p = 0.044, respectively). Further, the fluid levels of inflammatory cytokines were significantly higher in patients with biliary obstruction than in those without (p<0.05). These results suggest that in patients with biliary obstructions a hyperactive cytokine response occurs after an extensive hepatectomy and results in a high incidence of postoperative infection.
Department of Surgery, Omiya Red Cross Hospital, Yono, Japan.
F
F
Kimura
M
M
Miyazaki
T
T
Suwa
H
H
Itoh
S
S
Ambiru
H
H
Shimizu
K
K
Nakagawa
D000328:Adult; D000368:Aged; D002779:Cholestasis / Q000276:immunology*; D016207:Cytokines / Q000096:biosynthesis*; D005260:Female; D006498:Hepatectomy; D006801:Humans; D007375:Interleukin-1 / Q000032:analysis; D015850:Interleukin-6 / Q000097:blood; D008099:Liver / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis
D016207:Cytokines; D007375:Interleukin-1; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha