Nonalcoholic steatohepatits and liver steatosis modify partial hepatectomy recovery.
BACKGROUND
The impact of nonalcoholic fatty liver disease (NAFLD) comprising simple steatosis (NAFL) and steatohepatitis (NASH) on liver recovery after partial hepatectomy has not been evaluated. This pilot study investigated whether there is an effect of proven NAFLD on liver recovery.


METHODS
Thirty-one patients elected for partial hepatectomy were characterized and included into a prospective study. Liver samples were staged according to the NAFLD activity score. Liver function was measured by using the LiMAx method on postoperative days (POD) 1, 3, 5, and 10.


RESULTS
Nineteen patients were identified to suffer from NAFLD (NAFL, n = 11; NASH, n = 8). In NAFL, preoperative liver function (p = .48) and hepatic recovery on POD 1, 3, and 5 was comparable to controls (p > .05, respectively), while it was impaired on POD 10 (p = .022). NASH patients had preoperative enzymatic function comparable to controls (p = .10), but there was a trend to reduced levels on POD 1 (p = .082) and 5 (p = .062), which became significant on POD 10 (p = .003).


CONCLUSIONS
This study suggests that NAFLD impairs functional recovery assessed by LiMAx after partial hepatectomy.
1Department of General, Visceral and Transplantation Surgery, Charité - Universitaetsmedizin Berlin , Berlin , Germany.
Steffi
S
Hoppe
Christian
C
von Loeffelholz
Johan F
JF
Lock
Stephanie
S
Doecke
Bruno V
BV
Sinn
Anja
A
Rieger
Maciej
M
Malinowski
Andreas F H
AF
Pfeiffer
Peter
P
Neuhaus
Martin
M
Stockmann
D000230:Adenocarcinoma / Q000150:complications / Q000556:secondary / Q000601:surgery; D000328:Adult; D000368:Aged; D000886:Anthropometry; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000601:surgery; D018281:Cholangiocarcinoma / Q000150:complications / Q000601:surgery; D015179:Colorectal Neoplasms / Q000150:complications; D005234:Fatty Liver / Q000150:complications / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000150:complications* / Q000556:secondary / Q000601:surgery; D008115:Liver Regeneration; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000150:complications / Q000503:physiopathology; D009765:Obesity / Q000150:complications; D010865:Pilot Projects; D011184:Postoperative Period; D011446:Prospective Studies; D020127:Recovery of Function; D012720:Severity of Illness Index; D016037:Single-Blind Method
LiMAx test; breath test; liver function; liver regeneration; liver resection; methacetin; nonalcoholic fatty liver disease; nonalcoholic steatohepatitis