Messung der Leberfunktion nach großen abdominalchirurgischen Operationen mittels Maximal Liver Function Capacity Test (LiMAx Test) in Verbindung mit der farbkodierten Dopplersonographie der Lebergefäße und dem Indocyaningrün Test [thesis]

Gabriel Stöger, Universitätsbibliothek Der FU Berlin
2020
Major abdominal surgery inflicts a substantial trauma. A systemic inflammatory reaction (SIRS) triggered by the trauma puts the body under a lot of stress and results among other things in an altered blood flow. The change in blood flow may cause postoperative liver dysfunction and might lead to a higher risk of postoperative organ failure. This study tried to detect postoperative liver dysfunction and to compare different liver function tests. Furthermore, we investigated different surgical
more » ... fferent surgical approaches, minimal invasive laparoscopic versus conventional open technique. Materials and Methods: This study prospectively investigated 25 patients (7 female and 18 male; age between 55 and 72 years), who undertook major abdominal surgery electively at the surgical Department, Campus Mitte / Campus Virchow clinic, of the medical faculty Charité – university medicine berlin. Preoperational and on the postoperative days (PODs) 1 ,3 ,5 and 10 we conducted dynamic and static liver function tests, inflammation parameters were measured, the liver blood flow was measured by duplex sonography and the clinical course was documented. In addition we divided the patients into two groups separated by the surgical approach in order to compare the clinical outcomes of the different surgical techniques. Results: The research shows that the maximum liver function capacity-Test (LiMAx) values declined 123 µg/kg/h, or 2978 percent, on the 1. POD on average. 56% of the patients had a metabolic liver function capacity on the 1. POD of less than the cut off value. The indocyanine green-plasma-dilution-Rate (ICG-PDR) showed no decline whatsoever, it indicated increased levels instead. The static parameters for liver function showed an increase on the 1. POD as well. The inflammation parameters especially C-reactive protein (CRP) showed elevated levels postoperatively. The duplex sonography showed a hyperdynamic perfusion of the liver other than that there was no indication for abnormalities. The comparison between different surgical [...]
doi:10.17169/refubium-27289 fatcat:dej7q3orfzgdtgmxj4bd4ekhgm