Abstract
Background
Although prophylactic glucocorticoids have been used before liver resection to minimize
liver dysfunction, it is unknown whether treatment with glucocorticoids will accelerates
recovery from hyperbilirubinemia after liver resection.
Methods
In this open-label, randomized, controlled trial, patients with hyperbilirubinemia
(>2.5 × and ≤5 × the upper limit of normal) within 7 days after hepatic resection
were assigned randomly to the dexamethasone or control groups. For the dexamethasone
group, 10 mg, 10 mg, and 5 mg dexamethasone were administered intravenously on days
0, 1, and 2, respectively, after randomization. For the control group, patients received
standard treatment only. The primary outcome was time to recovery from hyperbilirubinemia
defined as the period from the day of randomization to the day when serum bilirubin
decreased to ≤1.5 times that of the upper limit of normal. Secondary outcomes were
the prevalence of postoperative complications, postoperative hospital stay, and hospital
expense.
Results
Between March 2016 and December 2017, 76 participants were enrolled (38 in each group).
Median time to recovery from hyperbilirubinemia was less in the dexamethasone group
than in the control group (2 vs 4 days, P < .001). Serum bilirubin levels were less in the dexamethasone group on days 1–3
after randomization (P < .05). The prevalence of infection, posthepatectomy liver failure, postoperative
hospital stay, and hospital expense were not different between the groups.
Conclusion
Dexamethasone accelerated recovery from hyperbilirubinemia and decreased serum bilirubin
levels without causing more side effects in patients after hepatectomy.
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Biography
Article info
Publication history
Published online: October 19, 2018
Accepted:
September 13,
2018
Received in revised form:
September 7,
2018
Received:
July 15,
2018
Identification
Copyright
© 2018 Elsevier Inc. All rights reserved.
