Protective effect of Verapamil on hepatic ischemia-reperfusion injury during hepatectomy in the cirrhotic patients with hepatocellular carcinoma.
OBJECTIVE
The purpose of the study is to evaluate the protective effects of Verapamil on hepatic ischemia-reperfusion injury in cirrhotic patients with HCC.


METHODS
A controlled study was performed on 86 consecutive patients with cirrhosis who underwent liver resection for suffering HCC. Thirty-nine patients were injected with Verapamil through the mesenteric vein before Pringle's maneuver to alleviate hepatic ischemia-reperfusion injury, while 47 patients were not.


RESULTS
The serum AST, ALT, and total bilirubin on days 1 and 3 were markedly lower in the Verapamil group than that in the control group postoperatively (AST, P < 0.001 and P < 0.001; ALT, P < 0.001 and P = 0.042; TB, P = 0.037 and 0.049; respectively). The serum hyluronic acid on day 1 was also significantly lower in Verapamil group than that in the control group (P < 0.01), but no marked difference on days 3 and 7. Meanwhile, the levels of IL6 on days 1 and 3 were markedly lower in the Verapamil group than that in control group (P < 0.05 and P < 0.01, respectively. The new Clavien's classification of surgical complications showed marked severity in the control group than that in the Verapamil group (P = 0.021), especially in the grade I level (P = 0.045).


CONCLUSIONS
Verapamil may serve as protective agent for hepatic ischemia-reperfusion injury in cirrhotic patients with HCC. Therefore, Verapamil can be used for treatment of patients who are to undergo hepatectomy with occlusion of hepatic blood flow.
Institute of Hepatobiliary Surgery, Southwest Hospital, Third Military Medical University, Chongqing, China. frankfxia@gmail.com
Feng
F
Xia
Shuguang
S
Wang
Min
M
Chen
Xiaojun
X
Wang
Xiaobin
X
Feng
Jiahong
J
Dong
D000328:Adult; D000368:Aged; D002121:Calcium Channel Blockers / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000601:surgery*; D015331:Cohort Studies; D004334:Drug Administration Schedule; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects*; D006801:Humans; D007275:Injections, Intravenous; D008103:Liver Cirrhosis / Q000188:drug therapy / Q000209:etiology / Q000601:surgery; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015427:Reperfusion Injury / Q000209:etiology / Q000473:pathology / Q000517:prevention & control*; D016896:Treatment Outcome; D014700:Verapamil / Q000627:therapeutic use*; D055815:Young Adult
D002121:Calcium Channel Blockers; D014700:Verapamil