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A study of the effect of splenectomy on hepatic functional reserve and structural damage in patients with chronic hepatitis C virus infection by non-invasive serum markers. A prospective study.
Int J Surg. 2008 Oct; 6(5):362-6.IJ

Abstract

Several beneficial effects of splenectomy on the liver integrity have been recently reported by both experimental and clinical studies. However, the effects of splenectomy on hepatic functional reserve and structural damage in patients with chronic hepatitis C (CHC) were not studied by objective evidence. The aim of this study was to assess the effect of splenectomy on hepatic functional reserve and structural damage in patients with CHC by non-invasive serum markers. The study involved 22 patients with histopathological diagnosis of CHC undergoing splenectomy for treatment of associated hypersplenism. The hepatic functional reserve and structural damage markers were assessed before and after splenectomy surgery on the 2nd and 60th postoperative days by aspartate aminotransferase to alanine aminotransferase (AST/ALT ratio), AST to platelet ratio index (APRI) and serum levels of gamma-glutamyl transferase (GGT), hyaluronic acid (HA), type IV collagen (CIV) and tissue inhibitor of metalloproteinase-1 (TIMP-1). After splenectomy, the levels of serum HA showed a significant decrease in relation to the preoperative values both in PO-1 (mean pre-splenectomy: 272+/-88.6 versus 185+/-77.4 ng/ml; P=0.01) and PO-2 (169+/-58.1 ng/ml; 0.017). The levels of type IV collagen showed a significant decrease in relation to the preoperative values both in PO-1 (mean pre-splenectomy: 208+/-134 versus 125+/-100 ng/ml; P=0.01) and PO-2 (121+/-74.7 ng/ml; P=0.02). Serum levels of TIMP-1 also showed a significant decrease in relation to the preoperative values both in PO-1 (mean pre-splenectomy: 764+/-571 versus 261+/-195 ng/ml; P=0.006) and PO-2 (149+/-110.1 ng/ml; P=0.004). There was no significant difference between PO-1 and PO-2 mean values for each of those serum markers. This study found that splenectomy induced a reduction of biochemical markers of liver functional reserve and fibrosis in patients with chronic hepatitis C which reflect a change in the processes involved in of liver fibrosis. However, it cannot be concluded whether this reflects a change in the rate of its progression or a prevention of further fibrosis.

Authors+Show Affiliations

Department of General Surgery, Theodore Bilharz Medical Research Institute (TBRI), Imbaba, 12411 Giza, Egypt. magdyelsebae@hotmail.comNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18662898

Citation

Elsebae, Magdy M A., and Nadia B. Abu-Zekri. "A Study of the Effect of Splenectomy On Hepatic Functional Reserve and Structural Damage in Patients With Chronic Hepatitis C Virus Infection By Non-invasive Serum Markers. a Prospective Study." International Journal of Surgery (London, England), vol. 6, no. 5, 2008, pp. 362-6.
Elsebae MM, Abu-Zekri NB. A study of the effect of splenectomy on hepatic functional reserve and structural damage in patients with chronic hepatitis C virus infection by non-invasive serum markers. A prospective study. Int J Surg. 2008;6(5):362-6.
Elsebae, M. M., & Abu-Zekri, N. B. (2008). A study of the effect of splenectomy on hepatic functional reserve and structural damage in patients with chronic hepatitis C virus infection by non-invasive serum markers. A prospective study. International Journal of Surgery (London, England), 6(5), 362-6. https://doi.org/10.1016/j.ijsu.2008.06.001
Elsebae MM, Abu-Zekri NB. A Study of the Effect of Splenectomy On Hepatic Functional Reserve and Structural Damage in Patients With Chronic Hepatitis C Virus Infection By Non-invasive Serum Markers. a Prospective Study. Int J Surg. 2008;6(5):362-6. PubMed PMID: 18662898.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A study of the effect of splenectomy on hepatic functional reserve and structural damage in patients with chronic hepatitis C virus infection by non-invasive serum markers. A prospective study. AU - Elsebae,Magdy M A, AU - Abu-Zekri,Nadia B, Y1 - 2008/06/21/ PY - 2008/05/14/received PY - 2008/06/16/accepted PY - 2008/7/30/pubmed PY - 2009/2/12/medline PY - 2008/7/30/entrez SP - 362 EP - 6 JF - International journal of surgery (London, England) JO - Int J Surg VL - 6 IS - 5 N2 - Several beneficial effects of splenectomy on the liver integrity have been recently reported by both experimental and clinical studies. However, the effects of splenectomy on hepatic functional reserve and structural damage in patients with chronic hepatitis C (CHC) were not studied by objective evidence. The aim of this study was to assess the effect of splenectomy on hepatic functional reserve and structural damage in patients with CHC by non-invasive serum markers. The study involved 22 patients with histopathological diagnosis of CHC undergoing splenectomy for treatment of associated hypersplenism. The hepatic functional reserve and structural damage markers were assessed before and after splenectomy surgery on the 2nd and 60th postoperative days by aspartate aminotransferase to alanine aminotransferase (AST/ALT ratio), AST to platelet ratio index (APRI) and serum levels of gamma-glutamyl transferase (GGT), hyaluronic acid (HA), type IV collagen (CIV) and tissue inhibitor of metalloproteinase-1 (TIMP-1). After splenectomy, the levels of serum HA showed a significant decrease in relation to the preoperative values both in PO-1 (mean pre-splenectomy: 272+/-88.6 versus 185+/-77.4 ng/ml; P=0.01) and PO-2 (169+/-58.1 ng/ml; 0.017). The levels of type IV collagen showed a significant decrease in relation to the preoperative values both in PO-1 (mean pre-splenectomy: 208+/-134 versus 125+/-100 ng/ml; P=0.01) and PO-2 (121+/-74.7 ng/ml; P=0.02). Serum levels of TIMP-1 also showed a significant decrease in relation to the preoperative values both in PO-1 (mean pre-splenectomy: 764+/-571 versus 261+/-195 ng/ml; P=0.006) and PO-2 (149+/-110.1 ng/ml; P=0.004). There was no significant difference between PO-1 and PO-2 mean values for each of those serum markers. This study found that splenectomy induced a reduction of biochemical markers of liver functional reserve and fibrosis in patients with chronic hepatitis C which reflect a change in the processes involved in of liver fibrosis. However, it cannot be concluded whether this reflects a change in the rate of its progression or a prevention of further fibrosis. SN - 1743-9159 UR - https://www.unboundmedicine.com/medline/citation/18662898/A_study_of_the_effect_of_splenectomy_on_hepatic_functional_reserve_and_structural_damage_in_patients_with_chronic_hepatitis_C_virus_infection_by_non_invasive_serum_markers__A_prospective_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1743-9191(08)00083-6 DB - PRIME DP - Unbound Medicine ER -