caa a22 4500 475802446 CHVBK 20180406123741.0 cr unu---uuuuu 170329e20000301xx s 000 0 eng 10.1007/s002689910058 doi (NATIONALLICENCE)springer-10.1007/s002689910058 Postoperative Hepatic Catabolic Stress Response in Patients with Cirrhosis and Chronic Hepatitis [Elektronische Daten] [Susanne B. Lausten, Talaat El-Sefi, Ibrahim Marwan, Tarek M. Ibrahim, Lone S. Jensen, Thorbjørn Grøfte, Frederik Andreasen, Hendrik Vilstrup, Ahmed A. Raouf, Amr Helmy, Steen L. Jensen] Open (OC) or laparoscopic (LC) cholecystectomy is considered a relative contraindication in patients with liver cirrhosis. The effect of LC and OC on the hepatic catabolic stress response was studied in patients with postnecrotic liver cirrhosis and chronic hepatitis to define the most suitable procedure from a metabolic point of view. Altogether 14 patients with cirrhosis and 14 with chronic hepatitis were randomized to LC or OC (n= 7 in each group). The increase in the functional hepatic nitrogen clearance (FHNC) was quantified. Changes in glucose, insulin, glucagon, cortisol, epinephrine, norepinephrine, and prostaglandin E2 (PGE2) were observed. There was no difference in FHNC between LC and OC in any of the patients. Among cirrhotic patients OC caused a 132% increase in FHNC (p < 0.05) and among the hepatitis patients a 69% increase (p < 0.05). In contrast, there was no significant increase following LC in any of the patients. OC increased fasting glucose and insulin in the hepatitis patients (p < 0.01 and p < 0.001, respectively) and in the cirrhosis group (p < 0.01 and p < 0.05, respectively). Alanine stimulation increased glucose in hepatitis patients after OC (p < 0.05) and after LC (p < 0.01). Stimulated glucagon increased after OC in the hepatitis group (p < 0.05). During stimulation cortisol was higher following LC in hepatitis patients (p < 0.01) and cirrhotic patients (p < 0.05). Fasting PGE2 was down-regulated after LC in hepatitis patients (p < 0.05) and cirrhotic patients (p < 0.01) and after OC in the hepatitis group (p < 0.001). FHNC is similar after LC and OC. Thus from a metabolic point of view, LC has no advantage over OC. by the Société Internationale de Chirurgie, 2000 Lausten Susanne B. Department of Surgery, Aarhus University Hospital, Nørrebrogade 44, DK-8000 Aarhus C, Denmark, DK aut El-Sefi Talaat Department of Surgery, Liver Institute, Menoufiya University, Shibin El Kom 32511, Menoufiya Governorate, Egypt, EG aut Marwan Ibrahim Department of Surgery, Liver Institute, Menoufiya University, Shibin El Kom 32511, Menoufiya Governorate, Egypt, EG aut Ibrahim Tarek M. Department of Surgery, Liver Institute, Menoufiya University, Shibin El Kom 32511, Menoufiya Governorate, Egypt, EG aut Jensen Lone S. Department of Surgery, Aarhus University Hospital, Nørrebrogade 44, DK-8000 Aarhus C, Denmark, DK aut Grøfte Thorbjørn Department of Medicine V, Aarhus University Hospital, Nørrebrogade 44, DK-8000 Aarhus C, Denmark, DK aut Andreasen Frederik Department of Clinical Pharmacology, Aarhus University, DK-8000 Aarhus C, Denmark, DK aut Vilstrup Hendrik Department of Medicine V, Aarhus University Hospital, Nørrebrogade 44, DK-8000 Aarhus C, Denmark, DK aut Raouf Ahmed A. Department of Clinical Chemistry, Liver Institute, Menoufiya University, Shibin El Kom 32511, Menoufiya Governorate, Egypt, EG aut Helmy Amr Department of Surgery, Liver Institute, Menoufiya University, Shibin El Kom 32511, Menoufiya Governorate, Egypt, EG aut Jensen Steen L. Department of Surgery, Aarhus University Hospital, Nørrebrogade 44, DK-8000 Aarhus C, Denmark, DK aut World Journal of Surgery Springer-Verlag 24/3(2000-03-01), 365-371 0364-2313 24:3<365 2000 24 268 https://doi.org/10.1007/s002689910058 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s002689910058 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Lausten Susanne B. Department of Surgery, Aarhus University Hospital, Nørrebrogade 44, DK-8000 Aarhus C, Denmark, DK aut NATIONALLICENCE 700 1- El-Sefi Talaat Department of Surgery, Liver Institute, Menoufiya University, Shibin El Kom 32511, Menoufiya Governorate, Egypt, EG aut NATIONALLICENCE 700 1- Marwan Ibrahim Department of Surgery, Liver Institute, Menoufiya University, Shibin El Kom 32511, Menoufiya Governorate, Egypt, EG aut NATIONALLICENCE 700 1- Ibrahim Tarek M. Department of Surgery, Liver Institute, Menoufiya University, Shibin El Kom 32511, Menoufiya Governorate, Egypt, EG aut NATIONALLICENCE 700 1- Jensen Lone S. Department of Surgery, Aarhus University Hospital, Nørrebrogade 44, DK-8000 Aarhus C, Denmark, DK aut NATIONALLICENCE 700 1- Grøfte Thorbjørn Department of Medicine V, Aarhus University Hospital, Nørrebrogade 44, DK-8000 Aarhus C, Denmark, DK aut NATIONALLICENCE 700 1- Andreasen Frederik Department of Clinical Pharmacology, Aarhus University, DK-8000 Aarhus C, Denmark, DK aut NATIONALLICENCE 700 1- Vilstrup Hendrik Department of Medicine V, Aarhus University Hospital, Nørrebrogade 44, DK-8000 Aarhus C, Denmark, DK aut NATIONALLICENCE 700 1- Raouf Ahmed A. Department of Clinical Chemistry, Liver Institute, Menoufiya University, Shibin El Kom 32511, Menoufiya Governorate, Egypt, EG aut NATIONALLICENCE 700 1- Helmy Amr Department of Surgery, Liver Institute, Menoufiya University, Shibin El Kom 32511, Menoufiya Governorate, Egypt, EG aut NATIONALLICENCE 700 1- Jensen Steen L. Department of Surgery, Aarhus University Hospital, Nørrebrogade 44, DK-8000 Aarhus C, Denmark, DK aut NATIONALLICENCE 773 0- World Journal of Surgery Springer-Verlag 24/3(2000-03-01), 365-371 0364-2313 24:3<365 2000 24 268 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer