Inflammation and pro-resolution inflammation after hepatobiliary surgery
Open accessAbstract
BACKGROUND: The magnitude of the perioperative inflammatory response plays a role in surgical outcomes. However, few studies have explored the mechanisms of the resolution of inflammation in the context of surgery. Here, we described the temporal kinetics of interleukin-6, cortisol, lipoxin A4, and resolvin D in patients who underwent oncologic liver resections. METHODS: All patients gave written informed consent. Demographic and perioperative surgical data were collected, along with blood samples, before surgery and on the mornings of postoperative days 1, 3, and 5. Interleukin-6, cortisol, lipoxin-A4, and resolvin D were measured in plasma. A P value < 0.05 was considered statistically significant. RESULTS: Forty-one patients were included in the study. Liver resection for colorectal metastatic disease was the most commonly performed surgery. The plasma concentrations of interleukin-6 were highest on day 1 after surgery and remained higher than the baseline up to postoperative day 1. Postoperative complications occurred in 14 (24%) patients. Cortisol concentrations spiked on postoperative day 1. The concentrations of lipoxin A4 and resolvin D were lowest on day 1 after surgery. CONCLUSIONS: The inflammatory response associated with hepatobiliary surgery is associated with low circulating concentrations of lipoxin A4 and resolvin D that mirror, in an opposite manner, the kinetics of interleukin 6 and cortisol. TRIAL REGISTRATION: NCT01438476.
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In Cata et al. 2017, there was no significant difference in median cytokine levels on POD1, 3, and 5 in patients with or without complications.
“However, there was no significant difference in median cytokine levels on POD1, 3, and 5 in patients with (n = 14/34%) or without complications.”
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 [28]
The Results (Laboratory results, Table 3; page unavailable) show no statistically significant differences on postoperative days 1, 3, or 5 between patients with and without complications. But the table’s cytokine comparison uses 9 patients with complications, not the 14 (34% of 41) stated in the citing sentence; the Results (Patients, Table 2; page unavailable) identify 14 patients with complications overall. (LLM, conf=0.88)
Experimental — accuracy not yet measuredThe 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 [28]
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 [28]
In Cata et al. 2017, there was a significant increase in IL-6 levels on POD1, 3, and 5 after surgery compared to preoperative baseline measurements.
“A secondary subgroup analysis of a RCT published by Cata et al. in 2017 (n = 41) reported a significant increase in IL-6 levels on POD 1, 3, and 5 after surgery compared to preoperative baseline measurements [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 [28]
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Research works printed but not linked: 17
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“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 [24–28].”
- Authors
- Cata, J. P., Velasquez, J. F., Ramirez, M. F., Vauthey, J.-N., Gottumukkala, V., Conrad, C., Kim, B. J., & Aloia, T.
- Affiliations
- The University of Texas MD Anderson Cancer Center (US)
- Corresponding author
- Cata, Juan P.
- ORCID
- Venue
- World Journal of Surgical Oncology
- Published
- 2017-08-10
- Volume
- 15
- Issue
- 1
- Pages
- 152-152
- ISSN
- 1477-7819 (ISSN-L)
- PMC
- PMC5556621
- OpenAlex
- W2742439946
- Cited by
- 30
- References
- 0
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 6 · 2023: 4 · 2022: 1 · 2021: 7 · 2020: 3 · 2019: 4 · 2018: 2
- FWCI
- 2.02
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- World Journal of Surgical Oncology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Cancer, Stress, Anesthesia, and Immune Response
- Health Sciences › Nursing › Nutrition and Dietetics › Fatty Acid Research and Health
- Life Sciences › Immunology and Microbiology › Immunology › Inflammation biomarkers and pathways
- Keywords
- hepatobiliary surgery, hepatectomy, interleukin-6, cortisol, lipoxin A4, perioperative inflammatory response, colorectal liver metastases, postoperative complications
- MeSH terms
- Aged, Anti-Inflammatory Agents, Biliary Tract Surgical Procedures, Docosahexaenoic Acids, Female, Hepatectomy, Humans, Hydrocortisone, Inflammation, Liver Neoplasms, Male, Middle Aged, Postoperative Complications, Prognosis, Time Factors, Colorectal Neoplasms, Interleukin-6, Treatment Outcome, Lipoxins, Perioperative Period
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