Kohler, Andreas; Perrodin, Stéphanie; De Gottardi, Andrea; Candinas, Daniel; Beldi, Guido (2020). Effectiveness of terlipressin for prevention of complications after major liver resection - A randomized placebo-controlled trial. HPB : official journal of The International Hepato-Pancreato-Biliary Association, 22(6), pp. 884-891. Elsevier 10.1016/j.hpb.2019.10.011
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BACKGROUND
Elevated portal pressure in response to major liver resection is associated with impaired liver regeneration and increased postoperative complications. Terlipressin, a splanchnic vasoconstrictor used for treatment of hepatorenal syndrome, was tested for reduction of complications and renal protection after liver resection.
METHODS
A randomized double-blinded placebo-controlled trial including patients undergoing elective major liver resection was performed. Terlipressin was administered to patients in the intervention group for five days. The primary outcome parameter was the incidence of a clinical composite endpoint of following liver specific complications 6 weeks after surgery: liver failure, ascites, bile leakage, intra-abdominal abscess and operative mortality. Postoperative kidney function was assessed as a secondary endpoint.
RESULTS
150 patients (mean age 63.4 years, 73.3% male) were included. No difference was found in the composite endpoint between the placebo and intervention group (32.8% versus 30.8%, relative risk 1.066, 95%CI 0.643 to 1.769, p = 0.85). Patients receiving terlipressin showed a significant lower decrease in postoperative estimated glomerular filtration rate compared to placebo (two way ANOVA, p = 0.005).
CONCLUSION
Perioperative administration of terlipressin during major liver surgery did not affect a composite endpoint of liver specific complications, but significantly protected from postoperative deterioration of kidney function compared to placebo. CLINICALTRIALS.
GOV IDENTIFIER
NCT01921985.
Item Type: |
Journal Article (Original Article) |
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Division/Institute: |
04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine > Hepatology 04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine > Visceral Surgery 04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine |
UniBE Contributor: |
Kohler, Andreas, Perrodin, Stéphanie Fabienne, De Gottardi, Andrea, Candinas, Daniel, Beldi, Guido Jakob Friedrich |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
1365-182X |
Publisher: |
Elsevier |
Language: |
English |
Submitter: |
Thi Thao Anh Pham |
Date Deposited: |
17 Jan 2020 14:49 |
Last Modified: |
05 Dec 2022 15:34 |
Publisher DOI: |
10.1016/j.hpb.2019.10.011 |
PubMed ID: |
31680011 |
BORIS DOI: |
10.7892/boris.137304 |
URI: |
https://boris.unibe.ch/id/eprint/137304 |
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