title: Strong association between frequency of intermittent inflow occlusion and transient increase in serum liver enzymes after hepatic resection.
abstract: OBJECTIVE
  Although significantly higher serum levels of liver transaminases are commonly observed after hepatic resection, the factors responsible for the increase and the association between the increase and the postoperative course remain unclear.
  
  
  METHODS
  The study population comprised 70 patients who had undergone hepatic resection except hepatectomy with vascular and biliary reconstruction. The relation between the perioperative factors and postoperative aspartic aminotransferase (AST) and alanine aminotransferase (ALT) elevations were analyzed. Outcome parameters, i.e., postoperative total bilirubin level, hospital stay and complications were also analyzed.
  
  
  RESULTS
  The average maximum postoperative serum AST and ALT levels were 444.6 IU/L and 390.1 U/L. None of the preoperative factors examined, such as AST, ALT, associated liver disease, Liver Damage Classification, intraoperative hypotension, intraoperative blood loss or types of liver resection, were significantly correlated with liver enzyme elevations. The only factor that was significantly correlated was frequency of intermittent inflow occlusion (p < 0.001). The elevations of AST and ALT were not significantly correlated with length of hospital stay and postoperative serum bilirubin level. ALT also was not correlated to complications, whereas AST was significantly correlated to the frequency of the postoperative complications.
  
  
  CONCLUSIONS
  The frequency of intermittent inflow occlusion is the only factor that affects the postoperative enzyme elevation.
authors.affiliation: Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Tokyo Medical and Dental University, Yushima 1-5-45, Bunkyo-Ku, Tokyo, Japan. teraken.srg1@tmd.ac.jp
authors.forename: Kenichi
authors.initials: K
authors.lastname: Teramoto
authors.forename: Noriaki
authors.initials: N
authors.lastname: Nakamura
authors.forename: Koji
authors.initials: K
authors.lastname: Ito
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kudo
authors.forename: Norio
authors.initials: N
authors.lastname: Noguchi
authors.forename: Susumu
authors.initials: S
authors.lastname: Takamatsu
authors.forename: Tohru
authors.initials: T
authors.lastname: Kawamura
authors.forename: Sinji
authors.initials: S
authors.lastname: Tanaka
authors.forename: Shigeki
authors.initials: S
authors.lastname: Arii
mesh_terms: D000410:Alanine Transaminase / Q000097:blood*; D001219:Aspartate Aminotransferases / Q000097:blood*; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects* / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010477:Perfusion
chemical_list: D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase