Hyperglycemia during hepatic resection: continuous monitoring of blood glucose concentration.
OBJECTIVE
This study assessed glucose metabolism via continuous intraoperative monitoring of blood glucose in patients undergoing hepatic resection.


METHODS
Thirty patients who underwent hepatic resection were enrolled. During hepatic resection, blood glucose concentration was continuously measured by an artificial pancreas.


RESULTS
Glucose concentrations followed a similar up-and-down pattern in all patients during the Pringle maneuver series. The concentration decreased marginally during the first clamping of the hepatoduodenal ligament but showed a rapid increase after unclamping. However, this increase declined with the number of Pringle cycles (P < .01). Patients with liver cirrhosis showed smaller elevations in glucose concentration after the first unclamping compared with patients without liver cirrhosis (P < .05).


CONCLUSIONS
The present study showed a rapid and profound transition in glucose concentration during hepatic resection. The mechanism underlying the transition of blood glucose concentration may involve glycogen break down within hepatocytes because of hypoxia.
Maeda
Hiromichi
H
Department of Surgery, Kochi Medical School, Kohasu-Okocho, Kochi 783-8505, Japan.
Okabayashi
Takehiro
T
Nishimori
Isao
I
Yamashita
Koichi
K
Sugimoto
Takeki
T
Hanazaki
Kazuhiro
K
D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001786:Blood Glucose / Q000032:analysis*; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D006943:Hyperglycemia / Q000209:etiology / Q000517:prevention & control*; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods*; D011336:Probability; D011446:Prospective Studies; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
D001786:Blood Glucose