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.
Xia
Feng
F
Institute of Hepatobiliary Surgery, Southwest Hospital, Third Military Medical University, Chongqing, China. frankfxia@gmail.com
Wang
Shuguang
S
Chen
Min
M
Wang
Xiaojun
X
Feng
Xiaobin
X
Dong
Jiahong
J
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