Serum Levels of Hyaluronic Acid during the Perioperative Period of Hepatic Resection

Akihiko Mizoe, Hikaru Fujioka, Takashi Azuma, Junichiro Furui, Tsutomu Tomioka, Takashi Kanematsu

Department of Surgery II, Nagasaki University School of Medicine

In the present study, in order to evaluate liver function during the perioperative period, serum levels of hyaluronic acid (HA) were measured. Blood samples were collected from 19 patients with hepatocellular carcinoma before hepatic resection and on the 1st, 3rd and 7th postoperative days (POD), and serum levels of HA were measured by the sandwich binding protein assay. The subjects were divided into 2 groups as follows. Group A, 14 patients, had an uneventful postoperative course, and Group B, 5 patients, had postoperative complications such as hepatic failure, liver abscess and intraperitoneal hemorrhage. The preoperative serum levels of HA had a significant correlation with the indocyanine green retention rate (ICG R15), the portal vein pressure, and the results of ^{99 m}Tc-GSA scintigraphy. The preoperative serum levels of HA in the patients with clinical stage II were significantly higher than those of the patients with clinical stage I (p<0.02). The rates of the postoperative complications in the patients with preoperative HA serum levels over 100 ng/ml were significantly higher than those in the patients with HA serum levels below 50 ng/ml (p<0.05). Moreover, the postoperative serum levels of HA in Group B tended to be higher than those in Group A. On the 1st POD, there was a significant difference in the serum levels of HA between Groups A and B (p<0.01), whereas there were no significant differences in other parameters of liver function. These results suggest that serum levels of HA are useful parameters for evaluating liver function and predicting the outcome after hepatic resection.

Key words
hyaluronic acid, hepatic resection, indocyanine green retention rate (ICG R15), portal vein pressure, ^{99 m}Tc-GSA

Reprint requests
Akihiko Mizoe Department of Surgery II, Nagasaki University School of Medicine
1-7-1 Sakamoto, Nagasaki, 852 JAPAN

Accepted
September 9, 1997

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