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Revista chilena de cirugía

versión On-line ISSN 0718-4026

Resumen

YANEZ C., Gonzalo et al. Effects of low dose corticosteroids in patients undergoing major hepatic resection with Pringle maneuver. Rev Chil Cir [online]. 2018, vol.70, n.6, pp.510-516. ISSN 0718-4026.  http://dx.doi.org/10.4067/s0718-40262018000600510.

Introduction:

Liver resections may be associated with high morbidity and mortality due to intraoperative bleeding. Pringle maneuver reduces this complication at the expense of ischemia-reperfusion injury. Current strategies to minimize reperfusion injury include the use of perioperative corticosteroids.

Objective:

To assess the use of methylprednisolone in low doses (< 500 mg) in patients submitted to major hepatic resection under Pringle maneuver in the incidence of ischemia-reperfusion injury, peri-operative morbidity, and mortality.

Material and Methods:

Retrospective study from the liver resections database undertaken between the years 2000-2015 in our center. One hundred and seventy-one major liver resections were done, in 62 under Pringle maneuver. Two groups were established: (A) Patients administered methylprednisolone immediately before Pringle maneuver (n = 27) and (B) those without steroid (n = 35). We assessed ischemia-reperfusion injury by measuring liver tests on days 1, 3 and 5.

Results:

Patients in group A had longer ischemia time (43 ± 3.3 vs. 27 ± 2.1 min, p < 0.05) than those of group B, and significantly lower elevation of serum phosphatase alkaline and bilirubin on days 1 and five post-hepatectomy. We did not observe any difference in bleeding magnitude, and there were no differences in morbidity or mortality.

Conclusions:

The use of low doses of methylprednisolone seems to diminish the impact of ischemia-reperfusion injury related to major hepatic resection under Pringle maneuver avoiding the adverse side effects of high dose steroid.

Palabras clave : hepatectomy; corticosteroids; reperfusion injury.

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