NUH ZAFER CANTÜRK1, CİHAN YILDIRIR1, NİHAT ZAFER UTKAN1, MUSTAFA DÜLGER2

1Cumhuriyet Üniversitesi Tıp Fakültesi, Genel Cerrahi Anabilim Dalı, SİVAS
2Kocaeli Üniversitesi Tıp Fakültesi, Genel Cerrahi Anabilim Dalı, KOCAELİ

Abstract

Liver is exposed to ischemic injury during different surgical procedures. During and after hepatic ischemia, various structural and metabolic impairment were previously reported. It has been reported that reperfusion of ischemic tissue could also cause tissue injury. Various agents were tested for prevention of these injuries. The objective of this study was to investigate and compare the usefulness of three different agents on hepatic ischemia/reperfusion injury (I/R).

We used a normothermic hepatic I/R model. Albino rats of Wistar strain were divided into five groups as follows: Sham group (SG), control group (CG), octreotide used group (OG), prostaglandin used group (PG) and diltiazem used group (DG). In each group, every rat was exposed to one hour ischemia and 45 minutes reperfusion. Each I/R performed group except control was pretreated with one of the above agents. The biochemical and histological parameters were determined at the end of the experiment. All rats were observed for postsurgical seven days and survival time and ratio were determined. We demonstrated that these three agents have beneficial effects, especially on survival ratio. Differentiation on biochemical parameters cannot be overlooked. The best survival ratio was determined for the DG to be (p<0.01), but SGPT, Alkalen phosphatase, lactic dehidrogenase and bilirübin levels were significantly lower in OG compared to those of other groups (p<0.01). SGOT value was significantly greater in OG compared to that of PG and DG (p<0.01). Histological alterations were not similar to functional differentiation during early phase.

In conclusion, comparison of different agents during hepatic I/R injury showed statistically significant differantiation, but survival ratio for each agent were not similiar to biochemical results during early phase. We suggest that there must be new and better studies againts postischemic liver injury.

Keywords: ISCHEMIA/REPERFUSION INJURY, LIVER, OCTREOID, PROSTAGLANDIN E1, DILTIAZEM