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Arterial ketone body ratio during hepatectomy
K Hanazaki1, M Wakabayashi, H Sodeyama
1Department of Surgery, Nagano Red Cross Hospital, Japan.
Hepato-Gastroenterology
|November 14, 1997
Summary
The arterial ketone body ratio (AKBR) does not reliably indicate liver mitochondrial function during hepatectomy. This study found AKBR changes did not predict liver viability or complications after temporary vascular occlusion.
Area of Science:
- Hepatobiliary Surgery
- Biochemical Markers
- Mitochondrial Physiology
Background:
- The arterial ketone body ratio (AKBR) is a proposed indicator of liver mitochondrial redox potential.
- Recent studies have questioned the reliability of AKBR as a biochemical marker.
Purpose of the Study:
- To investigate the effect of temporary vascular occlusion during hepatectomy on the AKBR.
- To determine if AKBR can predict liver viability and postoperative complications.
Main Methods:
- Studied 20 patients undergoing hepatectomy, divided into cirrhotic and non-cirrhotic groups.
- Applied temporary vascular occlusion (Pringle maneuver) to minimize blood loss.
- Measured arterial acetoacetate and beta-hydroxybutyrate concentrations to calculate AKBR before and after occlusion.
Main Results:
- AKBR increased post-ischemia in 25% of patients and post-reperfusion in 20% of the cirrhotic group.
- Changes in AKBR did not correlate with preoperative liver function.
- An AKBR < 0.7 did not consistently predict postoperative complications.
Conclusions:
- The AKBR is not a reliable predictor of liver viability during partial liver resection with temporary vascular occlusion.
- AKBR changes during hepatectomy do not consistently reflect liver function or predict outcomes.