J.Jpn. Surg. Soc.. 88(9): 1276-1278, 1987
Report on the annual meeting
EXPERIMENTAL AND CLINICAL STUDIES ON THE IMPAIRMENT OF WOUND HEALING IN LIVER CIRHHOSIS
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Department of Surgery, University of Tokyo, Tokyo, Japan Toshiharu Makishima, Hideaki Saito, Masaru Ishiyama, Yasuhiko Morioka |
The incidence of anastomotic leakage in our 173 surgical patients with liver cirrhosis was 11％, higher than the incidence with normal liver. Hepatic functional reserve had a significant relation with leak rate (Child A : 3.6％, B : 6.8％, C : 27.3％).
Patients with hypoalbuminemia (below 3.0g/dl) or ascites had a high incidence of anastomotic breakdown (20％) compared with those without hypoalbuminemia or ascites.
In experimental studies, liver cirrhosis was induced in rats, by oral administration of Dimethylaminoazobenzene (DAB) and Carbontetrachloride (CCI4), and all parameters were measured post-gastrectomy day 5 or 7.
The significant decrease in the number of inflammatory abdominal and gastric wounds indicate that wound healing was impaired in these cirrhotic rats.
There was close relationship between delayed type hypersensitivity for Dimethylaminoazobenzene (DNFB) and the number of infiltrating cells, suggesting that cell-mediated immunity bears a striking relationship with the impairment of the early phase of wound repair.
The intravenous administration of fresh plasma increased the number of inflammatory cells and collagen content in cirrhotic rats. It seems, therefore, that fresh plasma improves wound healing in liver cirhhosis and may be clinically useful.
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