Elective cholecystectomy increases plasma amino-acid clearance and hepatic capacity for urea synthesis for one week.
The importance of the liver in post-operative catabolism was studied in 6 cholecystectomy patients given a mixture of amino-acids as prime-continuous infusionś pre-operatively and on the 1st, 3rd, 6th and 12th post-operative day. The plasma clearance of total alpha-amino-nitrogen and of single amino-acids, the urea-nitrogen synthesis rate, and the functional hepatic nitrogen clearance were calculated. Surgery decreased fasting blood amino-nitrogen concentration by 15% (p < 0.01), and increased the plasma clearance of amino-nitrogen by 30% (P < 0.05) on the 1st, 3rd and 6th post-operative day. Surgery doubled the functional hepatic nitrogen clearance (p < 0.01) on the 1st, 3rd and 6th post-operative day. This indicates that post-operative stress catabolism is partly due to a hepatic condition by which the liver eliminates more amino-nitrogen despite lower amino-acid concentration in the blood, for one week post-operatively.
Heindorff
H
H
Department Surgery A, Frederiksborg County Hospital, Copenhagen, Denmark; Division of Hepatology A, Rigshospitalet, Copenhagen, Denmark.
Vilstrup
H
H
Almdal
T
T
Harvald
T
T
Nielsen
J
J
Dalsgaard
S
S