title: Preoperative serum hyaluronic acid level as a good predictor of posthepatectomy complications.
abstract: 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.
authors.affiliation: Department of Translational Medical Sciences, Division of Surgical Oncology, Nagaski University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nanashima
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Yamaguchi
authors.forename: Kenji
authors.initials: K
authors.lastname: Tanaka
authors.forename: Shinichi
authors.initials: S
authors.lastname: Shibasaki
authors.forename: Takashi
authors.initials: T
authors.lastname: Tsuji
authors.forename: Noboru
authors.initials: N
authors.lastname: Ide
authors.forename: Shigekazu
authors.initials: S
authors.lastname: Hidaka
authors.forename: Terumitsu
authors.initials: T
authors.lastname: Sawai
authors.forename: Tohru
authors.initials: T
authors.lastname: Nakagoe
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nagayasu
mesh_terms: 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
chemical_list: D014408:Biomarkers, Tumor; D006820:Hyaluronic Acid