Somatostatin prevents the postoperative increases in plasma amino acid clearance and urea synthesis after elective cholecystectomy
The importance of glucagon on postoperative changes in hepatic amino-nitrogen conversion were investigated in six patients undergoing elective cholecystectomy for uncomplicated gall stones. Patients were given infusions of somatostatin (bolus of 6 micrograms/kg followed by continuous infusion of 6 m...
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Published in | Gut Vol. 36; no. 5; pp. 766 - 770 |
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Main Authors | , , , , |
Format | Journal Article |
Language | English |
Published |
England
BMJ Publishing Group Ltd and British Society of Gastroenterology
01.05.1995
BMJ Publishing Group LTD |
Subjects | |
Online Access | Get full text |
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Summary: | The importance of glucagon on postoperative changes in hepatic amino-nitrogen conversion were investigated in six patients undergoing elective cholecystectomy for uncomplicated gall stones. Patients were given infusions of somatostatin (bolus of 6 micrograms/kg followed by continuous infusion of 6 micrograms/kg/h) from induction of anaesthesia to the end of investigation, the first postoperative day (30 hours). Controls were 16 patients undergoing the same procedures omitting the somatostatin infusion. In all patients blood concentration and plasma clearance of total alpha-amino-nitrogen, and amino acid stimulated rate of urea synthesis were measured. Elective cholecystectomy decreased blood alpha-amino-nitrogen concentration from mean (SEM) 2.9 (0.2) to 2.4 (0.1) mmol/l (p < 0.05), increased the clearance of total alpha-amino-nitrogen from 5.2 (0.3) to 6.6 (0.3) ml/s (p < 0.05), and increased the rate of amino acid stimulated urea synthesis from 27 (1) to 37 (2) mumol/s (p < 0.05) pointing to increased hepatic removal of amino-nitrogen at expense of plasma amino-nitrogen. Infusion of somatostatin prevented increase of glucagon for 24 hours after surgery, and prevented the negative changes in postoperative nitrogen homeostasis resulting from the postoperative changes in hepatic nitrogen conversion, suggesting glucagon as mediator. The exact mechanism remains in doubt, however, because of the multiple effects of somatostatin. |
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Bibliography: | istex:43CA4BA6B9F1DD8B31BFD7CDDAC1375A2722ABAC ark:/67375/NVC-RLMJP57H-X PMID:7797129 local:gutjnl;36/5/766 href:gutjnl-36-766.pdf ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
ISSN: | 0017-5749 1468-3288 1458-3288 |
DOI: | 10.1136/gut.36.5.766 |