Dynamics of portal and peripheral endothelin-1 in hepatic resection and its implication.
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.
Kuroda
N
N
First Department of Surgery, Hyogo College of Medicine, Nishinomiya, 663-8501, Japan.
Yamanaka
N
N
Kawamura
E
E
Tanaka
W
W
Kitayama
Y
Y
Imakita
M
M
Okamoto
E
E
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
D019332:Endothelin-1