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

Langenbeck's Archives of Surgery, ISSN: 1435-2443, Vol: 394, Issue: 6, Page: 1041-1046
2009
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Purpose: The purpose of the study is to evaluate the protective effects of Verapamil on hepatic ischemia-reperfusion injury in cirrhotic patients with HCC. Method: A controlled study was performed on 86 consecutive patients with cirrhosis who underwent liver resection for suffering HCC. Thirty-nine patients were injected with Verapamil through the mesenteric vein before Pringle's maneuver to alleviate hepatic ischemia-reperfusion injury, while 47 patients were not. Results: The serum AST, ALT, and total bilirubin on days 1 and 3 were markedly lower in the Verapamil group than that in the control group postoperatively (AST, P∈<∈0.001 and P∈<∈0.001; ALT, P∈<∈0.001 and P∈=∈0.042; TB, P∈=∈0.037 and 0.049; respectively). The serum hyluronic acid on day 1 was also significantly lower in Verapamil group than that in the control group (P∈<∈0.01), but no marked difference on days 3 and 7. Meanwhile, the levels of IL6 on days 1 and 3 were markedly lower in the Verapamil group than that in control group (P∈<∈0.05 and P∈<∈0.01, respectively. The new Clavien's classification of surgical complications showed marked severity in the control group than that in the Verapamil group (P∈=∈0.021), especially in the grade I level (P∈=∈0.045). Conclusion: Verapamil may serve as protective agent for hepatic ischemia-reperfusion injury in cirrhotic patients with HCC. Therefore, Verapamil can be used for treatment of patients who are to undergo hepatectomy with occlusion of hepatic blood flow. © 2009 Springer-Verlag.

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