N‐acetylcysteine administration does not improve patient outcome after liver resection. Issue 6 (7th January 2013)

• Record Type: Journal Article
• Authors: Robinson, Stuart M.; Saif, Rehan; Sen, Gourab; French, Jeremy J.; Jaques, Bryon C.; Charnley, Richard M.; Manas, Derek M.; White, Steven A.
• Is Part Of: HPB. Volume 15:Issue 6(2013:Jun.)
• Page Start: 457
• Page End: 462
• Publication Date: 2013-01-07
• Subjects: Liver -- Diseases -- Periodicals; Biliary tract -- Diseases -- Periodicals; Pancreas -- Diseases -- Periodicals; 616.362005
• DOI: 10.1111/hpb.12005
• Languages: English
• ISSNs: 1365-182X

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="hpb12005-sec-0001" sec-type="section"> <title>Background</title> <p>Post‐operative hepatic dysfunction is a major cause of concern when undertaking a liver resection. The generation of reactive oxygen species (ROS) as a result of hepatic ischaemia/reperfusion (I/R) injury can result in hepatocellular injury. Experimental evidence suggests that N‐acetylcysteine may ameliorate ROS‐mediated liver injury.</p> </sec> <sec id="hpb12005-sec-0002" sec-type="section"> <title>Methods</title> <p>A cohort of 44 patients who had undergone a liver resection and receiving peri‐operative N‐acetylcysteine (NAC) were compared with a further cohort of 44 patients who did not. Liver function tests were compared on post‐operative days 1, 3 and 5. Peri‐operative outcome data were retrieved from a prospectively maintained database within our unit.</p> </sec> <sec id="hpb12005-sec-0003" sec-type="section"> <title>Results</title> <p>Administration of NAC was associated with a prolonged prothrombin time on the third post‐operative day (18.4 versus 16.4 s; <italic>P</italic> = 0.002). The incidence of grades B and C liver failure was lower in the NAC group although this difference did not reach statistical significance (6.9% versus 14%; <italic>P</italic> = 0.287). The overall complication rate was similar between groups (32% versus 25%; <italic>P</italic> = ns). There were two peri‐operative deaths in the NAC group and one in the control group (<italic>P</italic> = NS).</p> </sec> <sec id="hpb12005-sec-0004" sec-type="section"> <title>Conclusion</title> <p>In spite of promising experimental evidence, this study was not able to demonstrate any advantage in the routine administration of peri‐operative NAC in patients undergoing a liver resection.</p> </sec> </abstract>