PREOPERATIVNA I POSTOPERATIVNA ANALIZA FUNKCIJE JETRE NAKON RESEKCIJE
Sažetak
Lekari koji se bave hirurgijom jetre ističu važnost temeljne preoperativne procene funkcionalnosti jetre i njenih rezervi, koja se sprovodi da bi se minimalizovao rizik od nastanka komplikacija u toku operacije, naročito kod bolesnika sa cirozom jetre, žuticom ili kod bolesnika koji su dugo na hemoterapiji.
U istraživanju je učestvovalo trideset bolesnika kojima je urađena hepatektomija zbog postojanja tumora, uključujući metastaze kolorektalnog karcinoma. Parametri su analizirani u dvema fazama: pre operacije i posle operacije. Praćeno je stanje parenhima jetre na osnovu određenih biohemijskih parametara funkcije jetre (aktivnost enzima alkalne fosfataze, aspartat aminotransaminaze (AST), alanin aminotransferaze (ALT), gama-glutamil transferaze (γGT), kao i bilirubina ‒ ukupnog bilirubina (engl. total bilirubin ‒ TBIL) i direktnog bilirubina (engl. direct bilirubin ‒ DBIL) ‒ laktat dehidrogenaze (LDH) i albumina) i parametara metaboličkog sindroma (glukoza, urea, kreatinin, krvni pritisak) preoperativno i postoperativno.
Ovo istraživanje je pružilo uvid u karakteristike oštećenja tkiva jetre nakon resekcije jetre, do kojeg se došlo na osnovu parametara za praćenje funkcije jetre. Budući da su zasnovani na primeni savremenih metoda i istraživanju odgovarajuće literature, ovi rezultati mogu pomoći u daljem unapređenju terapijskih postupaka i strategija za postoperativnu negu, s obzirom na to da pružaju korisne smernice za poboljšanje ishoda lečenja.
Reference
Balzan S, Belghiti J, Farges O, Ogata S, Sauvanet A, Delefosse D, et al. The "50-50 criteria" on postoperative day 5: an accurate predictor of liver failure and death after hepatectomy. Ann Surg 2005;242:824-8. [CrossRef][PubMed]
Chiarla C, Giovannini I, Giuliante F, Vellone M, Ardito F, Masi A, et al. Plasma bilirubin correlations in non-obstructive cholestasis after partial hepatectomy. Clin Chem Lab Med 2008;(46):1598-601. [CrossRef][PubMed]
Choukér A, Martignoni A, Schauer RJ, Dugas M, Schachtner T, Kaufmann I, et al. α-Gluthathione S-Transferase as an Early Marker of Hepatic Ischemia/Reperfusion Injury after Liver Resection. World J Surg 2005;(29):528–34. [CrossRef][PubMed]
Choukèr A, Schachtner T, Schauer R, Dugas M, Löhe F, Martignoni A, et al. Effects of Pringle manoeuvre and ischaemic preconditioning on haemodynamic stability in patients undergoing elective hepatectomy: a randomized trial. Br J Anaesth 2004;93(2):204-11. [CrossRef][PubMed]
Elias D, Lasser P, Rougier P, Ducreux M, Bognel C, Roche A. Frequency, technical aspects, results, and indications of major hepatectomy after prolonged intra-arterial hepatic chemotherapy for initially unresectable hepatic tumors. J Am Coll Surg 1995;180:213-9. [PubMed]
Gex L, Bernard C, Spahr L. Child-Pugh, MELD and Maddrey scores. Rev Med Suisse 2010;6(264):1803–4, 1806–8. [CrossRef][PubMed]
Giovannini I, Chiarla C, Giuliante F, Vellone M, Ardito F, Sarno G, et al. Analysis of the components of hypertransaminasemia after liver resection. Clin Chem Lab Med 2007;45(3):357-60. [CrossRef][PubMed]
Guglielmi A, Tripepi M, Salmaso L, Fedeli U, Ruzzenente A, Saia M. Trends in hospital volume and operative mortality in hepato-biliary surgery in Veneto region, Italy. Updates Surg 2023;75(7):1949–59. [CrossRef][PubMed]
Joliat GR, Kobayashi K, Hasegawa K, Thomson JE, Padbury R, Scott M, et al. Guidelines for Perioperative Care for Liver Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations 2022. World J Surg 2023;47(1):11–34. [CrossRef][PubMed]
Olthof PB, Huiskens J, Schulte NR, Wicherts DA, Besselink MG, Busch OR, et al. Postoperative peak transaminases correlate with morbidity and mortality after liver resection. HPB (Oxford) 2016;18(11):915-21. [CrossRef][PubMed]
Rahbari NN, Garden OJ, Padbury R, Brooke-Smith M, Crawford M, Adam R, et al. Posthepatectomy liver failure: a definition and grading by the International Study Group of Liver Surgery (ISGLS). Surgery 2011;149:713-24. [CrossRef][PubMed]
Reissfelder C, Rahbari NN, Koch M, Kofler B, Sutedja N, Elbers H, et al. Postoperative course and clinical significance of biochemical blood tests following hepatic resection. Br J Surg 2011;98:836-44. [CrossRef][PubMed]
Schindl MJ, Redhead DN, Fearon KC, Garden OJ, Wigmore SJ. The value of residual liver volume as a predictor of hepatic dysfunction and infection after major liver resection. Journal of Gastrointestinal Surgery 2005;9(2):137-44. [CrossRef][PubMed]
Stojanović M, Jeremić M, Bogićević A, Radojković M, Zlatić A, Jeremić Lj, et al. The influence of new surgical concept on results of liver resection. Acta Fac Med Naiss 2004;21(4):179-84.
Stojanovic M, Jeremic M, Radojkovic M, Jeremic-Savic L. Liver surgery. In: Jeremic M (Ed). Textbook of abdominal surgery (in Serbian). Niš: Medical faculty University of Niš; 2009. P. 1988-96.
Tanaka K, Shimada H, Matsuo K, Ueda M, Endo I, Togo S. Remnant liver regeneration after two-stage hepatectomy for multiple bilobar colorectal metastases. European Journal of Surgical Oncology (EJSO) 2007;33(3):329-35. [CrossRef][PubMed]
Taub R. Liver regeneration: from myth to mechanism. Nat Rev Mol Cell Biol 2004;5:836-47. [CrossRef][PubMed]
Van den Broek MA, Olde Damink SW, Dejong CH, Lang H, Malagó M, Jalan R, et al. Liver failure after partial hepatic resection: definition, pathophysiology, risk factors and treatment. Liver Int 2008;28:767–80. [CrossRef][PubMed]
