Significance of Prostaglandin E₁ Administration on Hepatic Hemodynamics during Cirrhotic Liver Resection

Michiyoshi Hisanaga, Yoshiyuki Nakajima, Hiromichi Kanehiro, Toshiyuki Fukuoka, Junichiro Taki, Atsushi Yoshimura, Masato Horikawa, Yukio Aomatsu, Saiho Ko, Kazuo Ohashi, Hiroshige Nakano, Tetsuji Fukushima*, Hitoshi Furuya*

First Department of Surgery, Department of Anesthesiology*, Nara Medical University

The purpose of this study was to investigate the effect of intravenous prostaglandin E₁ (PGE₁) administration on hepatic hemodynamics during cirrhotic liver resection. Twenty patients with hepatocellular carcinoma were divided into two groups consisting of 10 patients (group A) as controls, and 10 patients (group B) with PGE₁ infusion (0.03 µg/kg/min). Before and after hepatectomy, hepatic hemodynamics were examined with color Doppler ultrasonography. Arterial blood gases, mean arterial blood pressure (MAP), heart rate (HR), and arterial blood ketone body ratio (AKBR) were also determined. After hepatectomy, the portal flow rate fell to 56% from the preoperative value in group A, whereas in group B, PGE₁ produced increases of portal venous velocity and hepatic arterial diameter, which resulted in an increase of the portal flow rate to 162% and the arterial flow rate to 139%. MAP and HR were well maintained in group B. There were no differences between the two groups in pO₂, pCO₂, pH or base excess. Changes in AKBR values were 1.6±0.5 to 0.8±0.2 in group A, and 1.4±0.6 to 1.0±0.4 in group B. The decrease in AKBR was significantly suppressed in group B (p<0.01). These results suggest that PGE₁ has a preventive effect on postoperative hepatic damage through maintaining the hepatic energy charge levels achieved by increasing hepatic blood flow in hepatectomized patients with cirrhosis.

Key words
hepatocellular carcinoma with liver cirrhosis, hemodynamics before and after hepatectomy, prostaglandin E₁, analysis of hepatic blood flow with color Doppler ultrasonic device, arterial ketone bodv ratio

Reprint requests
Yoshiyuki Nakajima First Department of Surgery, Nara Medical University
840 Shijo-cho, Kashihara, 634 JAPAN

Accepted
January 12, 1994

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