Prospective randomized study of steroids in the prevention of ischaemic injury during hepatic resection with pedicle clamping.
BACKGROUND
The major drawback of hepatic pedicle clamping is ischaemia-reperfusion injury with impairment of liver function. Perioperative steroid administration has been advocated to reduce liver damage. The aim of this prospective, randomized study was to determine whether steroid administration can reduce liver injury and improve short-term outcome.


METHODS
Fifty-three patients undergoing liver resection were randomized to a steroid group (group 1) or to a control group (group 2); patients in group 1 received methylprednisolone 30 mg/kg 30 min before liver resection whereas those in group 2 did not. Serum levels of interleukin (IL) 6, total bilirubin, aspartate aminotransferase (AST) and alanine aminotransferase (ALT), and prothrombin time (PT) were measured. Length of stay, and type and number of complications were recorded.


RESULTS
Serum IL-6 levels were significantly lower in the steroid group than in the control group 24 h after surgery. Steroid administration significantly modified AST, ALT and PT levels only in patients with chronic liver disease. Overall and lung-related morbidity were not significantly different between the two groups.


CONCLUSIONS
Steroid administration suppresses serum IL-6 levels, but has no effect on short-term outcome.
Muratore
A
A
Department of Surgical Oncology, Istituto per la Ricerca e la Cura del Cancro, Candiolo, Torino, Italy. amuratore@ircc.mauriziano.it
Ribero
D
D
Ferrero
A
A
Bergero
R
R
Capussotti
L
L
D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D001219:Aspartate Aminotransferases / Q000097:blood; D003250:Constriction; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects*; D006801:Humans; D007262:Infusions, Intravenous; D015850:Interleukin-6 / Q000097:blood; D007430:Intraoperative Care / Q000379:methods; D007902:Length of Stay; D008099:Liver / Q000098:blood supply*; D008107:Liver Diseases / Q000601:surgery*; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage*; D008875:Middle Aged; D011446:Prospective Studies; D015427:Reperfusion Injury / Q000097:blood / Q000517:prevention & control*
D000893:Anti-Inflammatory Agents; D015850:Interleukin-6; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D008775:Methylprednisolone