EFFECT OF INTRAOPERATIVE ADMINISTRATION OF PROSTAGLANDIN E1 (PGE1) ON LIVER FUNCTION IN PATIENTS WITH RESECTABLE HEPATOCELLULAR CARCINOMA

Abstract

In spite of numerous reports on the cytoprotective effect of prostaglandin E1 (PGE1), its clinical usefulness is still controversial. We retrospectively studied the effect of the intraoperative administration of PGE1 (0.01_??_0.1μg/kg/min) on liver function in 77 patients with resectable hepatocellular carcinoma (HCC). The patients were divided into two groups, a PGE1 group (n=30) and control group (n=47). The liver function tests that were compared between the two groups on day 1, 3, 7, and 14 were: total bilirubin, glutamyl pyruvic transaminase (GPT), the hepaplastin test (HPT), and cholinesterase (ChE). We also compared the ratio of postoperative to preoperative level (Rpost/pre) to further evaluate sequential changes in liver function. The surgical factors, such as operation time, blood loss, and blood transfusion did not differ between the two groups. Postoperative decreases in HPT or ChE were ameliorated by the treatment with PGE1, and significant difference was observed in the Rpost/pre values of these two parameters (p<0.05). On the other hand, there were no significant differences in total bilirubin or GPT, either with actual values or Rpost/pre. These findings indicate that intraoperative administration of PGE1 enhanced hepatic synthesis of coagulation factors or ChE, and that its effect on ischemia-reperfusion injury was not significant in our clinical setting.