Abstract:
Objective To investigate the impacts of high-dose ulinastatin on the postoperative hepatic, renal function and inflammatory factors in patients with intrahepatic bile duct stones.
Methods Clinical data of 41 patients with intrahepatic bile duct stones who underwent hepatectomy at the Third Affiliated Hospital of Sun Yat-sen University from November 2014 to July 2016 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. Patients were divided into the ulinastatin group (n=23) and control group (n=18) according to whether high-dose ulinastatin was administered during the perioperative period. In ulinastatin group, 12 patients were males and 11 were females, aged (52±10) years on average. In control group, 8 patients were males and 10 were females, aged (50±9) years on average. Patients in ulinastatin group received continuous intravenous administration of high-dose ulinastatin from 1 d before surgery to 7 d after surgery, whereas those in control group did not receive ulinastatin anti-inflammatory treatment. Perioperative hepatic, renal function and level of inflammatory factors were observed in both groups. Clinical data were compared between two groups using t test.
Results In ulinastatin group, the levels of AST, ALT, TB, Scr, and BUN on the 1st and 3rd day after operation were significantly lower than those in control group(t=-2.03, -2.40, -2.08, -2.09, -2.21 and -2.06, -2.12 ,-2.08,-2.11, -2.59; P<0.05), whereas the levels of ALB were significantly higher than those in control group (t=2.11 and 2.48; P<0.05). At postoperative 7 d, the levels of ALT, TB and Scr in ulinastatin group were significantly lower than those in control group (t=-2.56, -2.41, -2.35; P<0.05). At postoperative 1, 3, and 7 d, the levels of IL-6 and TNF-α in ulinastatin group were significantly lower than those in control group (t=-2.05, -2.39 and -2.69, -2.70 and -2.45, -2.62; P<0.05), whereas the levels of IL-10 were significantly higher than those in control group (t=2.41, 2.67, 2.54; P<0.05).
Conclusions High-doseulinastatin can effectively protect the hepatic and renal function, control the inflammatory response and promote the postoperative recovery of patients with intrahepatic bile duct stones.
Key words:
Cholelithiasis,
Hepatectomy,
Inflammation,
Liver function tests,
kidney function tests
Hui Luo, Hongli Gan, Dan Hu, Ailing Hu, Yong Huang. Impacts of high-dose ulinastatin on hepatic, renal function and inflammatory factors in patients with intrahepatic bile duct stones[J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2018, 07(04): 319-322.