Preoperative serum hyaluronic acid level as a good predictor of posthepatectomy complications.
OBJECTIVE
We evaluated the efficiency of measuring hyaluronic acid (HA) levels preoperatively in patients with injured liver disease as a predictor of complications after hepatectomy.


METHODS
We examined patients who underwent hepatectomy for liver tumors secondary to chronic viral liver diseases or obstructive jaundice.


RESULTS
The preoperative HA level correlated significantly with the indocyanine green retention rate at 15 min, liver activity at 15 min by technetium-99m galactosyl human serum albumin scientigraphy, and the histopathological activity index. It was also significantly elevated in patients with severe fibrosis caused by cirrhosis. After hepatectomy, the HA level was increased on postoperative day (PODS) 7, but had normalized by POD 28. The preoperative HA level tended to correlate with the regeneration rate on POD 28, and was significantly higher in patients with prolonged ascites or hepatic failure postoperatively. Multivariate analysis identified a serum HA level above 200 or 150 ng/ml as the only significant predictor of postoperative hepatic failure or long-term ascites, respectively (P < 0.05).


CONCLUSIONS
Our findings indicate that the preoperative serum HA level is a good predictor of postoperative complications in patients who undergo hepatectomy for injured liver disease.
Nanashima
Atsushi
A
Department of Translational Medical Sciences, Division of Surgical Oncology, Nagaski University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan.
Yamaguchi
Hiroyuki
H
Tanaka
Kenji
K
Shibasaki
Shinichi
S
Tsuji
Takashi
T
Ide
Noboru
N
Hidaka
Shigekazu
S
Sawai
Terumitsu
T
Nakagoe
Tohru
T
Nagayasu
Takeshi
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D014408:Biomarkers, Tumor / Q000097:blood*; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D006820:Hyaluronic Acid / Q000097:blood*; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery* / Q000821:virology; D008115:Liver Regeneration / Q000502:physiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000175:diagnosis*; D011237:Predictive Value of Tests; D011300:Preoperative Care / Q000379:methods; D011336:Probability; D011379:Prognosis; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D016019:Survival Analysis; D016896:Treatment Outcome
D014408:Biomarkers, Tumor; D006820:Hyaluronic Acid