title: Dynamics of portal and peripheral endothelin-1 in hepatic resection and its implication.
abstract: BACKGROUND
  The liver and portal circulation contribute to production and clearance of endothelin-1 (ET-1). This study was undertaken to investigate what variables relate to the dynamics of ET-1 in hepatic resection and its clinical implication.
  
  
  METHODS
  On 20 patients with (n = 8) or without (n = 12) chronic liver disease who underwent hepatic resection, peripheral arterial and portal venous ET-1 were serially measured to determine a correlation with pre-, intra-, and postoperative variables.
  
  
  RESULTS
  The preoperative factors with which the portal ET-1 showed a positive correlation were the indocyanine green retention rate at 15 min (ICG R15) and portal venous pressure. The ET-1 clearance, as calculated from the difference between the portal and the peripheral ET-1 concentrations, was also correlated with the ICG R15. The peripheral ET-1 elevated significantly in the patients with increasing intraoperative blood loss or hepatic inflow occlusion. An increase in the portal ET-1 was correlated with an elevation of portal venous pressure after hepatectomy. Postoperative increase in serum bilirubin was closely correlated with the peripheral ET-1 at closure.
  
  
  CONCLUSIONS
  The peripheral and portal ET-1 are correlated with not only preoperative hepatic reserve and portal venous pressure but also invasiveness of hepatectomy and postoperative course.
authors.affiliation: First Department of Surgery, Hyogo College of Medicine, Nishinomiya, 663-8501, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Kuroda
authors.forename: N
authors.initials: N
authors.lastname: Yamanaka
authors.forename: E
authors.initials: E
authors.lastname: Kawamura
authors.forename: W
authors.initials: W
authors.lastname: Tanaka
authors.forename: Y
authors.initials: Y
authors.lastname: Kitayama
authors.forename: M
authors.initials: M
authors.lastname: Imakita
authors.forename: E
authors.initials: E
authors.lastname: Okamoto
mesh_terms: D016063:Blood Loss, Surgical; D019332:Endothelin-1 / Q000097:blood*; D005260:Female; D006498:Hepatectomy; D006801:Humans; D007432:Intraoperative Period; D008099:Liver / Q000098:blood supply / Q000378:metabolism; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D017082:Portal Pressure / Q000502:physiology; D011169:Portal Vein / Q000378:metabolism*; D011184:Postoperative Period; D013997:Time Factors
chemical_list: D019332:Endothelin-1