The significance of post-hepatectomy changes in polymorphonuclear elastase and endotoxin levels

We studied the association between polymorphonuclear elastase and endotoxin levels and complications following hepatectomy. The blood concentrations of polymorphonuclear elastase, endotoxin, fibrinogen and C-reactive protein were examined with the aim of clarifying their involvement in postoperative complications in twenty-five patients who underwent hepatectomy. Polymorphonuclear elastase increased significantly (p < 0.01) on the second postoperative day compared with preoperative levels, and decreased on the seventh postoperative day. The difference in the polymorphonuclear elastase level with and without liver cirrhosis was significant (p < 0.05) on the second postoperative day. Endotoxin changed in a manner similar to polymorphonuclear elastase, but no positive correlation was found between endotoxin and polymorphonuclear elastase. Neither parameter showed any significant positive correlation with the volume of hepatic resection. We were unable to find any relationship between the degree of elevation of endotoxin and complication after hepatectomy; further study will be needed.