Effects of preoperative statin on liver reperfusion injury in major hepatic resection: A pilot study
Abstract
Unlabelled During major liver resection, ischemia reperfusion injury occurs resulting in adverse outcome. Animal studies have demonstrated the beneficial effect of statins on hepatic ischemic injury, but no clinical studies have been performed. Twenty consecutive patients undergoing major hepatic resection were included and were randomized into two groups. The study group (n = 10) patients received oral atorvastatin 40 mg for 3 days prior to surgery, including the day of surgery, and the control group (n = 10) received a placebo. Outcomes were assessed at 4, 24, and 72 h by measurement of serum liver enzymes and cytokines-IL-1, IL-6, CRP, and TNF α. The two groups were evenly matched for demographic and perioperative variables. The AST levels were significantly higher in the control group compared with the study group at 4 h (909.60 ± 222 vs. 362.6 ± 129 U/L), 24 h (215.30 ± 86.9 vs. 605.30 ± 186.1 U/L) and 72 h (84.30 ± 32.7 vs. 204.70 ± 67.5) (p < 0.001). Plasma IL-1 values in the study group showed significantly lower values compared with the control group (p < 0.001) postoperatively. Plasma IL-6 values postoperatively showed significantly lower mean values as compared with the mean of the control population (p < 0.001). TNF α values at 4, 24, and 72 h postoperatively comparable in the two groups (p = 0.011) (p = 0.096) and (p = 0.237), respectively. Statins have the potential for pharmacological prevention of IRI. Further studies would be needed to substantiate the role of statins in prevention of IRI during liver resection.Clinical trial registration PGIMER, Chandigarh-NK/1081/MS/12182-83.
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The review included 12 publications with a collective 589 patients, with a range of 14 to 128 patients.
“A final number of 12 publications with a collective 589 patients (range 14–128) were included in this review (Table 1) [20,21,22,23,24,25,26,27,28,29,30,31].”
From The Role of Perioperative Interleukin-6 Serum Levels on Liver Dysfunction and Infectious Complications After Hepatectomy—A Systematic Review (2025) · cites this paper as [26]
The included studies were all prospective single-center observational cohort studies, except for five partly secondary analyses of RCTs with comparably low numbers of patients and potential statistical limitations.
“These studies (all published between 2001 and 2023) were all prospective single-center observational cohort studies, except for five (partly secondary analysis of) RCTs with comparably low numbers of patients and potential statistical limitations [24,25,26,27,28].”
From The Role of Perioperative Interleukin-6 Serum Levels on Liver Dysfunction and Infectious Complications After Hepatectomy—A Systematic Review (2025) · cites this paper as [26]
In Sarin et al. 2016, POD1 IL-6 levels were significantly lower in the statin intervention group compared to the control group (83.83 vs. 144.43 pg/mL; p = 0.001).
“POD1 IL-6 levels were significantly lower in the statin intervention group compared to the control group (83.83 vs. 144.43 pg/mL; p = 0.001).”
From The Role of Perioperative Interleukin-6 Serum Levels on Liver Dysfunction and Infectious Complications After Hepatectomy—A Systematic Review (2025) · cites this paper as [26]
Dietary factors play a role in regulating metabolism and are a safe and economic way to treat LMD.
“Recent studies have shown that dietary factors play a role in regulating metabolism, and making it a safe and economic way to treat LMD [4].”
From Regulatory Efficacy of the Polyunsaturated Fatty Acids from Microalgae Spirulina platensis on Lipid Metabolism and Gut Microbiota in High-Fat Diet Rats (2018) · cites this paper as [4]
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“Seven studies reported on perioperative factors potentially confounding IL-6 serum levels in univariable analysis [20,22–26].”
- Authors
- Sarin, S., Kaman, L., Dahiya, D., Behera, A., Medhi, B., & Chawla, Y.
- Affiliations
- Post Graduate Institute of Medical Education and Research (IN)
- Corresponding author
- Kaman, Lileswar
- Venue
- Updates in Surgery
- Published
- 2016-05-10
- Volume
- 68
- Issue
- 2
- Pages
- 191-197
- ISSN
- 2038-131X (ISSN-L)
- 2038-3312
- OpenAlex
- W2354595720
- Cited by
- 18
- References
- 21
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 1 · 2023: 1 · 2022: 1 · 2021: 3 · 2020: 2 · 2019: 3 · 2018: 3 · 2017: 1
- FWCI
- 2.58
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Updates in Surgery (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Organ Transplantation Techniques and Outcomes
- Health Sciences › Medicine › Hepatology › Hepatocellular Carcinoma Treatment and Prognosis
- Health Sciences › Medicine › Surgery › Cardiac and Coronary Surgery Techniques
- Keywords
- statins, atorvastatin, hepatic ischemia-reperfusion injury, major hepatectomy, hepatectomy, postoperative liver enzymes, interleukin-1, interleukin-6, TNF-α, C-reactive protein, anti-inflammatory activity, perioperative drug therapy
- MeSH terms
- Female, Hepatectomy, Humans, Liver, Male, Middle Aged, Pilot Projects, Postoperative Complications, Preoperative Care, Reperfusion Injury, Treatment Outcome, Hydroxymethylglutaryl-CoA Reductase Inhibitors
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