Ischemic preconditioning provides no additive clinical value in liver resection of cirrhotic and non-cirrhotic patients under portal triad clamping: a prospective randomized controlled trial.
OBJECTIVE
The clinical value of ischemic preconditioning (IP) on patients undergoing hepatectomy under portal triad clamping (PTC) is uncertain, especially for patients with liver cirrhosis. Hence, we conducted a prospective randomized controlled trial to test whether IP could protect liver against ischemic reperfusion (IR) injury after hepatectomy under PTC.


METHODS
One hundred patients, including 67 with cirrhosis, undergoing hepatectomy with PTC were randomly divided into IP and control groups. Liver function tests at postoperative days 1, 3, and 7 as well as postoperative morbidity, mortality, and duration of hospitalization were compared between the two groups.


RESULTS
The general clinical characteristics between both groups were comparable. The duration of the operation, the amount of intraoperative blood loss, and the need and amount of perioperative blood transfusion were similar in both groups. The postoperative levels of serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin, and albumin were not statistically different between the two groups. In addition, the morbidity and mortality rates and the duration of hospitalization were similar in both groups.


CONCLUSIONS
IP did not improve liver tolerance to IR injury after hepatectomy under PTC. Therefore, the clinical use of IP cannot be recommended as a standard procedure before PTC.
Liver Cancer Institute and Zhongshan Hospital, Fudan University, Shanghai, China.
Bogen
B
Ye
Department of Hepatobiliary Surgery of the First Affiliated Hospital of Anhui Medical University, Hefei, China.
Hongchuan
H
Zhao
Department of Hepatobiliary Surgery of the Second Affiliated Hospital of Anhui Medical University, Hefei, China.
Hui
H
Hou
Department of Hepatobiliary Surgery of the First Affiliated Hospital of Anhui Medical University, Hefei, China.
Guobin
G
Wang
Department of Hepatobiliary Surgery of the First Affiliated Hospital of Anhui Medical University, Hefei, China.
Fubao
F
Liu
Department of Hepatobiliary Surgery of the First Affiliated Hospital of Anhui Medical University, Hefei, China.
Yijun
Y
Zhao
Department of Hepatobiliary Surgery of the First Affiliated Hospital of Anhui Medical University, Hefei, China.
Zhigong
Z
Zhang
Department of Hepatobiliary Surgery of the First Affiliated Hospital of Anhui Medical University, Hefei, China.
Kun
K
Xie
Department of Laboratory Center of the First Affiliated Hospital of Anhui Medical University, Hefei, China.
Lixin
L
Zhu
Department of Hepatobiliary Surgery of the First Affiliated Hospital of Anhui Medical University, Hefei, China. Electronic address: xiaoping_geng@126.com.
Xiaoping
X
Geng
D003250:Constriction; D005260:Female; D006498:Hepatectomy; D006801:Humans; D019194:Ischemic Preconditioning; D008099:Liver / Q000098:blood supply*; D008103:Liver Cirrhosis / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011169:Portal Vein; D011446:Prospective Studies