title: Urinary trypsin inhibitor attenuates liver enzyme elevation after liver resection.
abstract: BACKGROUND
  Urinary trypsin inhibitors (UTI) have been widely used for the treatment of diseases including disseminated intravascular coagulation, shock, and pancreatitis. Since UTI synthesis is likely to be reduced in patients who have undergone liver resection, the incidence of inflammatory reactions may be increasing accordingly. For such patients, the liver enzyme increases after the operation can reflect liver damage. The purpose of this study was to examine if ulinastatin can inhibit liver enzyme increases after liver resection.
  
  
  METHODS
  After receiving Institutional Review Board approval, a retrospective chart review was performed on 201 patients who underwent hepatic resection from 2006 to 2010. We divided the records into the control (n = 69) and ulinastatin (n = 132) groups according to the use of intraoperative ulinastatin and compared the preoperative and postoperative laboratory test results. The number of patients who had > 400 U/L elevation of aspartate transaminase (AST) level after surgery was compared between the 2 groups.
  
  
  RESULTS
  The mean AST, alanine transaminase (ALT), and total bilirubin levels after liver resection were significantly lower in the ulinastatin group than in the control group. The number of patients who showed an AST > 400 U/L after liver resection was significantly higher in the control group (odds ratio = 3.02).
  
  
  CONCLUSIONS
  Ulinastatin attenuates the elevation of hepatic enzymes and bilirubin after liver resection.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Chonnam National University Medical School, Gwangju, Korea.
authors.forename: Cheol-Won
authors.initials: CW
authors.lastname: Jeong
authors.forename: Cha-Sup
authors.initials: CS
authors.lastname: Lee
authors.forename: Seong-Heon
authors.initials: SH
authors.lastname: Lee
authors.forename: Hye Jin
authors.initials: HJ
authors.lastname: Jeung
authors.forename: Sang-Hyun
authors.initials: SH
authors.lastname: Kwak