Ischemic preconditioning may reduce hyperglycemia associated with intermittent Pringle maneuver in hepatic resection

Hanazaki, Kazuhiro; Munekage, Masaya; Ichikawa, Kengo; Okabayashi, Takehiro

doi:10.1007/s00534-012-0535-5

Cited by 1 publication

(1 citation statement)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…During hepatectomy, blood glucose levels shoot up sharply after Pringle maneouvre due to augmentation of glycogenolysis as a result of hypoxia [82] . In line with this concept, Hanazaki et al [83] suggested that ischemic preconditioning may reduce the hyperglycemia caused by disturbances of hepatic glucose mechanism in association with ischemic reperfusion injury. Preoperative fasting combined with surgical stress response reduces liver glycogen stores and promotes insulin resistance with hyperglycemia [2] .…”

Section: Postoperative Glycemic Controlmentioning

confidence: 94%

Enhanced recovery after surgery in liver surgery

Kumar¹,

Jha²,

Negi³

2018

MIS

View full text Add to dashboard Cite

Enhanced recovery after surgery (ERAS) or fast-track surgery protocols, have been implemented across surgical fields with positive impact on outcomes. These protocols represent a standardized and evidence-based multimodal perioperative strategy founded on a series of measures aiming to attenuate the physical and psychological stress responses to surgical insults, and to potentiate the postoperative rehabilitation of patients. The successful adoption of ERAS protocols in various specialties enabled its gradual acceptance in the complex field of liver surgery. Even though many elements have been adapted especially from colorectal surgery, a few elements of ERAS protocol are unique to liver surgery. The goals of enhanced recovery can be achieved with efforts beginning at the first interaction on outpatient basis. Core elements of this multidisciplinary effort include pre-operative counseling, shortened preoperative fasting, no pre-anesthetic medication, targeted antimicrobial prophylaxis and early withdrawal, preventing and treating of postoperative nausea and vomiting, minimally invasive approaches, avoidance of postoperative nasogastric decompression, preventing hypothermia, optimal perioperative fluid management, selective use of abdominal drains, early urinary catheter removal, optimal pain control, early oral feeding and mobilization. The available evidence from recent randomized controlled studies and meta-analyses comparing ERAS programs with traditional care in liver surgery suggests that length of hospital stay is shortened without increasing morbidity, mortality or readmission rates.

show abstract

Section: Postoperative Glycemic Controlmentioning

confidence: 94%