Hyperglycemia during hepatic resection: continuous monitoring of blood glucose concentration

Abstract 

Background and aims

This study assessed glucose metabolism via continuous intraoperative monitoring of blood glucose in patients undergoing hepatic resection.

Methods

Thirty patients who underwent hepatic resection were enrolled. During hepatic resection, blood glucose concentration was continuously measured by an artificial pancreas.

Results

Glucose concentrations followed a similar up-and-down pattern in all patients during the Pringle maneuver series. The concentration decreased marginally during the first clamping of the hepatoduodenal ligament but showed a rapid increase after unclamping. However, this increase declined with the number of Pringle cycles (P < .01). Patients with liver cirrhosis showed smaller elevations in glucose concentration after the first unclamping compared with patients without liver cirrhosis (P < .05).

Conclusions

The present study showed a rapid and profound transition in glucose concentration during hepatic resection. The mechanism underlying the transition of blood glucose concentration may involve glycogen break down within hepatocytes because of hypoxia.

Keywords: Surgical stress, Hyperglycemia, Pringle procedure, Continuous blood glucose monitoring, STG-22, Hepatic resection