Kayvan Mohkam1, Benjamin Darnis2, Zoé Schmitt3, Serge Duperret3, Christian Ducerf2, Jean-Yves Mabrut4. 1. Department of General Surgery and Liver Transplantation, Croix-Rousse University Hospital, Hospices Civils de Lyon, 103 Grande Rue de la Croix-Rousse, 69317 Cedex 04, Lyon, France; Equipe Mixte de Recherche 3738, Ecole Doctorale EDISS 205, Université Claude Bernard Lyon 1, Villeurbanne, France; Ecole de Chirurgie de Lyon, Université Claude Bernard Lyon 1, Lyon, France. 2. Department of General Surgery and Liver Transplantation, Croix-Rousse University Hospital, Hospices Civils de Lyon, 103 Grande Rue de la Croix-Rousse, 69317 Cedex 04, Lyon, France; Ecole de Chirurgie de Lyon, Université Claude Bernard Lyon 1, Lyon, France. 3. Ecole de Chirurgie de Lyon, Université Claude Bernard Lyon 1, Lyon, France; Intensive Care Unit, Croix-Rousse University Hospital, Hospices Civils de Lyon, Lyon, France. 4. Department of General Surgery and Liver Transplantation, Croix-Rousse University Hospital, Hospices Civils de Lyon, 103 Grande Rue de la Croix-Rousse, 69317 Cedex 04, Lyon, France; Equipe Mixte de Recherche 3738, Ecole Doctorale EDISS 205, Université Claude Bernard Lyon 1, Villeurbanne, France; Ecole de Chirurgie de Lyon, Université Claude Bernard Lyon 1, Lyon, France. Electronic address: jean-yves.mabrut@chu-lyon.fr.
Abstract
BACKGROUND: Somatostatin may prevent the small-for-size syndrome in subjects undergoing extended hepatectomy by decreasing portal pressure. METHODS: Twenty pigs underwent 70% hepatectomy (H70 group, n = 7), 90% hepatectomy (H90 group, n = 7), or sham laparotomy (control group, n = 6). Splanchnic hemodynamics was measured before and after an intraoperative infusion of somatostatin. RESULTS: The portal vein flow normalized to liver weight increased in both H70 and H90 groups (from 125 ± 42 to 342 ± 82 mL/min/100g, P = .031 and from 140 ± 46 to 530 ± 241, P = .016, respectively). The hepatic venous pressure gradient (HVPG) increased in the H90 group only (from 5.5 ± 5.8 to 13 ± 4.9 mm Hg, P = .004). Somatostatin decreased portal vein flow normalized to liver weight in both H70 and H90 groups (from 408 ± 224 to 360 ± 227 mL/min/100g, P = .031 and from 560 ± 190 to 466 ± 189 mL/min/100g, P = .016), and restored a normal HVPG in the H90 group (from 14.3 ± 4.8 to 7.7 ± 6.1 mm Hg, P = .047). CONCLUSIONS: Somatostatin restores a normal HVPG in the setting of small-for-size syndrome and can be considered as an effective pharmaceutical modality of portal inflow modulation after extended hepatectomy.
BACKGROUND:Somatostatin may prevent the small-for-size syndrome in subjects undergoing extended hepatectomy by decreasing portal pressure. METHODS: Twenty pigs underwent 70% hepatectomy (H70 group, n = 7), 90% hepatectomy (H90 group, n = 7), or sham laparotomy (control group, n = 6). Splanchnic hemodynamics was measured before and after an intraoperative infusion of somatostatin. RESULTS: The portal vein flow normalized to liver weight increased in both H70 and H90 groups (from 125 ± 42 to 342 ± 82 mL/min/100g, P = .031 and from 140 ± 46 to 530 ± 241, P = .016, respectively). The hepatic venous pressure gradient (HVPG) increased in the H90 group only (from 5.5 ± 5.8 to 13 ± 4.9 mm Hg, P = .004). Somatostatin decreased portal vein flow normalized to liver weight in both H70 and H90 groups (from 408 ± 224 to 360 ± 227 mL/min/100g, P = .031 and from 560 ± 190 to 466 ± 189 mL/min/100g, P = .016), and restored a normal HVPG in the H90 group (from 14.3 ± 4.8 to 7.7 ± 6.1 mm Hg, P = .047). CONCLUSIONS:Somatostatin restores a normal HVPG in the setting of small-for-size syndrome and can be considered as an effective pharmaceutical modality of portal inflow modulation after extended hepatectomy.
Authors: Mohammad Golriz; Maryam Ashrafi; Elias Khajeh; Ali Majlesara; Christa Flechtenmacher; Arianeb Mehrabi Journal: Can J Gastroenterol Hepatol Date: 2017-08-29
Authors: Jurgen van Limmen; Piet Wyffels; Frederik Berrevoet; Aude Vanlander; Laurent Coeman; Patrick Wouters; Stefan De Hert; Luc De Baerdemaeker Journal: BMC Anesthesiol Date: 2020-09-22 Impact factor: 2.217