J.Jpn. Surg. Soc.. 90(10): 1692-1696, 1989

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Original article

BLOOD CONCENTRATION OF GRANULOCYTIC ELASTASE, SURGICAL INVASION AND POSTOPERATIVE COMPLICATIONS
ーWITH SPECIAL REFERENCE TO SURGICAL RESECTION OF LIVER CIRRHOSIS

The blood concentrations of granulocytic elastase (PMN-E), α₁-antitripsin and α₂-macroglobulin were examined to evaluate their clinical significance in patients who underwent hepatectomy due to liver cancer with liver cirrhosis (n=31, Group A), due to liver cancer with chronic hepatitis (n=5, Group B) and without hepatic complications (n=6, Group C) and other major surgeries (n=10, Group D). In all groups, on the first postoperative day, blood PMN-E increased rapidly more than three times of the preoperative levels. Despite a decreasing tendency from postoperative Day 3, the value in Group A reincreased on Day 5. The peak PMN-E values within 24 postoperative hours showed significant positive correlations (p＜0.01) with the amounts of hemorrhage and blood transfusion during operation in all groups. Even in 18 cases without blood transfusion, peak PMN-E was positively correlated (p＜0.05) with the operative time and the amount of blood loss during operation.
In Group A, patients in whom blood PMN-E increased after postoperative Day 3 developed infection and adult respiratory distress syndrome. After temporary reduction after operation except for Group C, blood α₁-antitripsin increased from postoperative Day 3. However, α₁-antitripsin in Group A was significantly low (p＜0.01), compared to the increased levels in Group C and D, Blood α₂-macroglobulin showed no tendency of postoperative increase in all groups.

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