Impact of hepatic vascular inflow exclusion on postoperative arterial lactate level in patients undergoing hepatectomy
10.3760/cma.j.issn.1007-631X.2010.05.010
- VernacularTitle:入肝血流阻断对肝切除术后血乳酸水平的影响
- Author:
Yiyao XU
;
Xin LU
;
Xinting SANG
;
Haitao ZHAO
;
Yilei MAO
;
Shunda DU
;
Haifeng XU
;
Tianyi CHI
;
Zhiying YANG
;
Shouxian ZHONG
;
Jiefu HUANG
- Publication Type:Journal Article
- Keywords:
Hepatectomy;
Lactic acid;
Hyperlactatemia;
Vascular inflow occlusion of the liver
- From:
Chinese Journal of General Surgery
2010;25(5):373-376
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the impact of vascular inflow occlusion of the liver on arterial lactate level and pH value. Methods In this study, 68 patients who underwent hepatectomy from January 2006 to December 2008 were retrospectively studied. The patients were assigned to one of the three study groups according the vascular inflow status: clamping of portal vein and hepatic artery in the hepatic pedicle (n = 20), hemihepatectomy under total hemihepatic vascular exclusion (THVE, n = 22), and non-vascular occlusion (n = 26). Postoperative arterial blood gas analysis including systemic arterial lactate concentration, and liver and renal function tests were performed. Results Systemic arterial blood lactate levels significantly elevated in the portal clamping and THVE groups (5.53 ±2. 31 mmol/L and 5.62 ±2.52mmol/L, respectively), compared to the non-occlusion group (3. 37 ± 1.56 mmol/L, P < 0. 05) ;significant increase in arterial HCO3- level was observed in the THVE group in comparison to the nonocclusion group (19. 68 ± 3. 82) mmol/L vs. (21.65 ± 2. 48) mmol/L, (P < 0. 05). There were no significant differences as to the changes of pH values, liver and renal function tests between the three groups. Conclusions Vascular inflow deprivation may result in significantly increased arterial lactate level. Thus, intense surveillance of blood lactate level with prompt treatment is necessary to prevent postoperative hyperlactatemia and metabolic acidosis.
