Effects of terlipressin in the management of ascites after hepatectomy: a prospective trial

Abstract

Objective To investigate the efficacy of terlipressin in the management of ascites after hepatectomy.Methods Fifty-four patients with hepatic cancer who were admitted to the Union Hospital of Tongji Medical College from January 2010 to January 2011 were randomly divided into the research group (28 patients) and control group (26 patients) according to the random number table.Patients in the research group were treated by the terlipressin and albumin,and patients in the control group were treated by furosemide and albumin.The volume of ascites,urine output,renal function,electrolyte balance,recovery after hepatectomy and complications of the 2 groups were investigated.All data were analyzed by the t test,chi-square test or Fisher exact probability.Results The volume of postoperative maximum drainage was (351 ± 174) ml in the research group,which was significantly lesser than (551 ±233)ml in the control group (t =3.604,P ＜ 0.05).The total urine output of the research group was significantly higher than that of the control group at postoperative day 1 and day 3 (t =5.816,2.722,P ＜ 0.05).All patients had normal renal function except 1 patient was complicated by hepatorenal syndrome in the control group.Electrolyte imbalance was observed in 3 patients (11％) in the research group and 9 patients (35％) in the control group,with a significant difference (x2 =4.456,P ＜ 0.05).The postoperative time of intensive care unit stay and the anal exsufflation time of the research group were (22 ± 12)hours and (68 ±24)hours,which were similar to (23 ± 10)hours and (76 ±28)hours of the control group (t =0.331,1.130,P ＞0.05).The abdominal drainage tube removal time and hospital stay of the research group were (102 ± 42)hours and (15 ±4)days,which were significantly shorter than (140 ±50) hours and (18 ±5)days (t =3.032,2.443,P ＜ 0.05).There were 1 patient in the research group complicated with high blood pressure and 1 patient in the control group with cardiac arrhythmia.The incidences of adverse reaction were 4％ (1/28) in the research group and 4％ (1/26) in the control group,with no significant difference (P ＞ 0.05).Conclusion Terlipressin is effective in the management of ascites after hepatectomy,has less effect on electrolyte balance and is beneficial to quick recovery. Key words: Liver neoplasms; Ascites ; Hepatectomy; Terlipressin