The effect of a perioperative steroid pulse on surgical stress in hepatic resection

Abstract

Little has been reported on the control of cytokine release, which is induced by surgical stress. The aim of this study was to investigate the effect of a perioperative short-term steroid pulse on surgical stress. Seventeen patients with a non-cholestatic liver, who underwent hepatic resection, were included in this study. The patients were classified into two groups consisting of a control group (n = 11) and a steroid pulse group (n = 6), in whom 30 mg/kg of methylprednisolone was intravenously administered 3 hours before the operation, and thereafter 1 gram of methylprednisolone was also intravenously administered both immediately after operation and on postoperative day 1. Interleukin 6 was serially measured, and the perioperative clinical parameters including C-reactive protein were compared between both the control and the steroid pulse groups. The IL-6 values immediately after operation, as well as at postoperative days 1 and 3 in the steroid pulse group were significantly lower than those in the control group. The value of the C-reactive protein at postoperative day 3 in the steroid pulse group was significantly lower than that in the control group, and the postoperative peak value of bilirubin as well as the incidence of postoperative complications in the control group tended to be higher than those in the steroid pulse group. In addition, the steroid pulse demonstrated no adverse side effects. A perioperative short-term steroid pulse using methylprednisolone is thus suggested to reduce surgical stress by decreasing cytokine release.