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Metabolism Before and After Hepatic Lobectomy for Cancer: Studies in Twenty-Three Patients

Metabolism Before and After Hepatic Lobectomy for Cancer: Studies in Twenty-Three Patients Abstract Introduction Although the peritoneal cavity was the first visceral compartment to be surgically violated, the liver has been the last organ to yield to surgical resection. This has been due to the fact that uncontrollable hemorrhage and infection often occurred during the early attempts at hepatic surgery. With improved surgical techniques and the development of wide-spectrum antibiotics, these dangers have been largely overcome. Another major fear which has shrouded surgical thought pertaining to hepatic surgery has been that of the body's ability to withstand the trauma incident to the removal of a large portion of the liver and concern as to whether the residual hepatic tissue could maintain a normal metabolic balance. Inasmuch as the liver is responsible for at least 250 known physiochemical processes, the fear regarding the maintenance of normal metabolism following major hepatic resection was not entirely unfounded. Although animal experiments have demonstrated that significant portions of References 1. Ariel, I. M.; Pack, G. T., and Rhoads, C. P.: Metabolic Studies in Patients with Cancer of the Gastrointestinal Tract: VII. The Influence of Gastric Surgery upon the Chemical Composition of the Liver , Ann. Surg. 116:924-927, 1942.Crossref 2. Geller, W., and Tagnon, H. J.: Liver Dysfunction Following Abdominal Operations: The Significance of Postoperative Hyperbilirubinemia , Arch. Int. Med. 86:908-916, 1950.Crossref 3. Islami, A. H.; Pack, G. T., and Hubbard, J. C.: Regenerative Hyperplasia of the Cirrhotic Liver Following Partial Hepatectomy , Cancer 11:663-686, 1958.Crossref 4. Islami, A. H.; Pack, G. T., and Hubbard, J. C.: Comparative Tolerance to Poisons of Normal Liver Tissue and Regenerated Liver Tissue After Major Hepatectomy , J. Lab. & Clin. Med. 53:586-590, 1959. 5. Islami, A. H.; Pack, G. T.; Miller, T. R.; Vanamee, P.; Randall, H. T., and Roberts, K. E.: Postoperative Course Following Total Right Hepatic Lobectomy , Surgery 39:551-556, 1956. 6. Markowitz, J.; Rappaport, A., and Scott, A. C.: Prevention of Liver Necrosis Following Ligation of Hepatic Artery , Proc. Soc. Exper. Biol. & Med. 70:305, 1949. 7. Molander, D. W.; Friedman, M., and LaDue, J. S.: Serum Cholinesterase in Hepatic and Neoplastic Disease: A Preliminary Report , Ann. Int. Med. 41:1139-1151, 1954. 8. Molander, D. W., and Pack, G. T.: Unpublished data. 9. Pack, G. T.; Higgins, G. K., and Molander, D. W.: Unpublished data. 10. Pack, G. T., and Islami, A. H.: The Epiphenomena of Total Right Hepatic Lobectomy Editorial , Surgery 40:611-614, 1956. 11. Pack, G. T., and Miller, T. R.: The Treatment of Hepatic Tumors , New York J. Med. 53:2205-2207, 1953. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png A.M.A. Archives Surgery American Medical Association

Metabolism Before and After Hepatic Lobectomy for Cancer: Studies in Twenty-Three Patients

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Publisher
American Medical Association
Copyright
Copyright © 1960 American Medical Association. All Rights Reserved.
ISSN
0096-6908
DOI
10.1001/archsurg.1960.01290210153030
Publisher site
See Article on Publisher Site

Abstract

Abstract Introduction Although the peritoneal cavity was the first visceral compartment to be surgically violated, the liver has been the last organ to yield to surgical resection. This has been due to the fact that uncontrollable hemorrhage and infection often occurred during the early attempts at hepatic surgery. With improved surgical techniques and the development of wide-spectrum antibiotics, these dangers have been largely overcome. Another major fear which has shrouded surgical thought pertaining to hepatic surgery has been that of the body's ability to withstand the trauma incident to the removal of a large portion of the liver and concern as to whether the residual hepatic tissue could maintain a normal metabolic balance. Inasmuch as the liver is responsible for at least 250 known physiochemical processes, the fear regarding the maintenance of normal metabolism following major hepatic resection was not entirely unfounded. Although animal experiments have demonstrated that significant portions of References 1. Ariel, I. M.; Pack, G. T., and Rhoads, C. P.: Metabolic Studies in Patients with Cancer of the Gastrointestinal Tract: VII. The Influence of Gastric Surgery upon the Chemical Composition of the Liver , Ann. Surg. 116:924-927, 1942.Crossref 2. Geller, W., and Tagnon, H. J.: Liver Dysfunction Following Abdominal Operations: The Significance of Postoperative Hyperbilirubinemia , Arch. Int. Med. 86:908-916, 1950.Crossref 3. Islami, A. H.; Pack, G. T., and Hubbard, J. C.: Regenerative Hyperplasia of the Cirrhotic Liver Following Partial Hepatectomy , Cancer 11:663-686, 1958.Crossref 4. Islami, A. H.; Pack, G. T., and Hubbard, J. C.: Comparative Tolerance to Poisons of Normal Liver Tissue and Regenerated Liver Tissue After Major Hepatectomy , J. Lab. & Clin. Med. 53:586-590, 1959. 5. Islami, A. H.; Pack, G. T.; Miller, T. R.; Vanamee, P.; Randall, H. T., and Roberts, K. E.: Postoperative Course Following Total Right Hepatic Lobectomy , Surgery 39:551-556, 1956. 6. Markowitz, J.; Rappaport, A., and Scott, A. C.: Prevention of Liver Necrosis Following Ligation of Hepatic Artery , Proc. Soc. Exper. Biol. & Med. 70:305, 1949. 7. Molander, D. W.; Friedman, M., and LaDue, J. S.: Serum Cholinesterase in Hepatic and Neoplastic Disease: A Preliminary Report , Ann. Int. Med. 41:1139-1151, 1954. 8. Molander, D. W., and Pack, G. T.: Unpublished data. 9. Pack, G. T.; Higgins, G. K., and Molander, D. W.: Unpublished data. 10. Pack, G. T., and Islami, A. H.: The Epiphenomena of Total Right Hepatic Lobectomy Editorial , Surgery 40:611-614, 1956. 11. Pack, G. T., and Miller, T. R.: The Treatment of Hepatic Tumors , New York J. Med. 53:2205-2207, 1953.

Journal

A.M.A. Archives SurgeryAmerican Medical Association

Published: Apr 1, 1960

References