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Monitoring of inflammatory substances (such as interleukins, CRP, albumine), and markers of organ dysfunction (such as creatinine, proenkephaline, amylase, troponine, IFABP and lactate) during elective liver resection. The study also includes monitoring of hemodynamic parameters, blood loss and postoperative complications. Results are to be used för power calculation for future trials.
During hepatic surgery, blood and urine samples will be obtained at 3 times during surgery, at 3 h after resection of liver, at 24 h after resection of liver and at post operative day 2, and subsequntly analyzed for the above mentioned substances. Routine labs will be monitored until patient is discharged from hospital. During surgery, hemodynamic parameters will be monitored by Picco calculations. Urine output and blood loss will be registred.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Elective Hepatic Surgery | Patientes undergoing elective hepatic resection, managed according to departement routine. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| elective surgery, according to deprtement routine | Procedure | none, descriptive study |
|
| Measure | Description | Time Frame |
|---|---|---|
| Ischemic Intestinal Damage | rise in IFABP in nanograms/ml, | from day of surgery until 24-48 hours postoperatively |
| Kidney injury | as described by KDIGO (Kidney Disease Improving Global Outcomes) criteria | from day of surgery and approximately 1 week onwards |
| Intestinal Bacterial Transloction | Rise in D-lactate in micromol/ml | from day of surgery until 24-48 hours postoperatively |
| Kidney injury | proenkephaline increase in pico mol/l | from day of surgery until 24-48 hours postoperatively |
| Kidney injury | NAG units/g increase in urine. | from day of surgery until 24-48 hours postoperatively |
| Measure | Description | Time Frame |
|---|---|---|
| Description of Inflammatory Response | Changes in MCP-1, SDF-1, IL-1beta, TNF-alfa, IL-6, IL-8, IL-10 and HMBG-1, in blood samples obtained during and after heptaic surgery | from day of surgery and approximately 1 week onwards |
| Measure | Description | Time Frame |
|---|---|---|
| blood loss | need of transfusion | from day of surgery and approximately 1 week onwards |
Inclusion Criteria:
ASA I-III Patient has given informed consent to participate in study.
Exclusion Criteria:
preoperative kidney failure (E-GFR >30), current infection treatment with corticosteroids coagulopathy surgical or anatomical conditions that makes patient unsuitable for participation (for example reoperation, need of vascular bypass, single tumor)
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patients scheduled for open liver resection, ASA class I-III.
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| Name | Affiliation | Role |
|---|---|---|
| Sven-Erik Ricksten, MD, PhD, professor | Sahlgrenska University Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| SahlgrenskaUH | Gothenburg | Västra Götaland County | 41345 | Sweden |
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| ID | Term |
|---|---|
| D007249 | Inflammation |
| D006470 | Hemorrhage |
| ID | Term |
|---|---|
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| ID | Term |
|---|---|
| D017558 | Elective Surgical Procedures |
| ID | Term |
|---|---|
| D013514 | Surgical Procedures, Operative |
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Plasma, serum and urinary samples