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HPB Surgery
Volume 7, Issue 1, Pages 43-49

Factors Relating to Coagulation, Fibrinolysis and Hepatic Damage After Liver Resection

1The First Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
2First Department of Surgery, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602, Japan

Received 10 September 1992; Accepted 11 September 1992

Copyright © 1993 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


A survey of the blood of twenty-two patients who had undergone hepatic resection was performed. Serum levels of α-2 plasmin inhibitor-plasmin complex initially decreased from 1.58 ± 0.31 μg/ml on the preoperative day (PREOP), to 0.92 ± 0.14 μ/ml on the first postoperative day (POD 1), and then increased to 3.13 ± 0.92 μg/ml on the seventh postoperative day (POD 7) (mean ± SE)). Thrombin-anti-thrombin III complex (14.2 ± 4.3 ng/ml on PREOP and 26.0 ± 4.1 ng/ml on POD 7 (mean ± SE)) and D-dimer (335 ± 96 ng/ml on PREOP and 1859 ± 258 ng/ml on POD 7 (mean ± SE)) increased in the early postoperative stage. The level of 6-keto-prostaglandin F1α increased after the operations (from 13.2 ± 1.8 pg/ml on PREOP to 37.8 ± 12.8 pg/ml on POD 7 (mean ± SE)). The level of thromboxane B-2 decreased at first, and then gradually increased and returned to its preoperative level on POD 7 (144.7 ± 43.8 pg/ml on PREOP, 57.6 ± 27.5 pg/ml on POD1 and 152.5 ± 58.4 pg/ml on POD 7 (mean ± SE)). Superoxide dismutase activity increased at first, and then gradually decreased, postoperatively (2.8 ± 0.5 NU/ml on PREOP, 4.8 ± 0.8 NU/ml on POD1 and 2.6 ± 0.3 NU/ml on POD 7 (mean ± SE)). That is, biodefensive reactions which protect patients against the shift to disseminated intravascular coagulation (DIC) were inferred with by the increase in antiplatelet aggregation, despite the activation of coagulation and fibrinolytic mechanisms after hepatic resection.