Protective effect of Verapamil on hepatic ischemia–reperfusion injury during hepatectomy in the cirrhotic patients with hepatocellular carcinoma

Xia, Feng; Wang, Shuguang; Chen, Min; Wang, Xiaojun; Feng, Xiaoshan; Dong, Jiahong

doi:10.1007/s00423-009-0491-y

Cited by 6 publications

(1 citation statement)

References 17 publications

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“…Laparoscopic Pringle maneuver combined with low CVP obviously decreased intraoperative blood loss and tended to reduce the proportion of blood transfusion, which made LH safer. Meanwhile, low inflow and easy outflow reduce the amount of residual blood in the liver, which inevitably increases the severity of IRI ( 42 , 43 ). The enrollment design of this study had a chronological sequence and the appropriate laparoscopic Pringle maneuver was gradually determined and more frequently used in the development of LH in our center, which made the Pringle maneuver used more in the ERAS group.…”

Section: Discussionmentioning

confidence: 99%

Enhanced Recovery After Surgery in Patients With Hepatocellular Carcinoma Undergoing Laparoscopic Hepatectomy

et al. 2021

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Objective: To compare the effectiveness and safety of enhanced recovery after surgery (ERAS) in patients with hepatocellular carcinoma (HCC) undergoing laparoscopic hepatectomy.Methods: From September 2016 to June 2019, 282 patients were enrolled, and ERAS was implemented since March 2018. All indicators related to surgery, liver function, and postoperative outcomes were included in the analysis. Propensity score matching (PSM) identified 174 patients for further comparison.Results: After PSM, the clinicopathological baselines were well-matched. The group showed significantly less intraoperative blood loss (100.00 [100.00–200.00] vs. 200.00 [100.00–300.00] ml, P = 0.001), fewer days before abdominal drainage tube removal (4.00 [3.00–4.00] days vs. 4.00 [3.00–5.00] days, P = 0.023), shorter hospital stay after surgery (6.00 [5.00–6.00] days vs. 6.00 [6.00–7.00] days, P < 0.001), and reduced postoperative morbidity (18.39 vs. 34.48%, P = 0.026). The proportion of patients with a pain score ≥ 4 was significantly lower in the ERAS group within the first 2 days after surgery (1.15 vs. 13.79% and 8.05 vs. 26.44%, P = 0.002 and P = 0.001, respectively). Pringle maneuver was performed more frequently in the ERAS group (70.11 vs. 18.39%, P < 0.001), and a significantly higher postoperative alanine aminotransferase level was also observed (183.40 [122.85–253.70] vs. 136.20 [82.93–263.40] U/l, P = 0.026). The 2-year recurrence-free survival was similar between the two groups (72 vs. 71%, P = 0.946).Conclusions: ERAS programs are feasible and safe and do not influence mid-term recurrence in HCC patients undergoing laparoscopic hepatectomy.

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Section: Discussionmentioning

confidence: 99%