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Clinical results of N-acetylcysteine after major hepatic surgery: a review

  • Review
  • Published:
Journal of Hepato-Biliary-Pancreatic Surgery

Abstract

Background/Purpose

Ischemia/reperfusion injury is thought to play an important role in postoperative liver dysfunction and morbidity following major liver surgery. N-acetylcysteine may be protective by serving as a precursor to glutathione and replenishing intracellular stores, in addition to other mechanisms. The purpose of this review is to summarize the clinical evidence that N-acetylcysteine may reduce liver dysfunction and the postoperative complications following major liver surgery.

Methods

A PubMed (MEDLINE) search was performed using the search terms “N-acetylcysteine”, “Mucomyst”, “liver”, and “surgery” to identify all relevant articles published in English prior to February 2007.

Results

Seventy-three articles were identified, and of these, there were seven studies that involved human patients undergoing orthotopic liver transplantation (six randomized controlled trials and one retrospective study).

Conclusions

The evidence that routine use of N-acetylcysteine reduces ischemia/reperfusion injury and prevents complications after major liver surgery is not conclusive. The available studies may have been limited by small sample sizes, and heterogeneous outcome measures prevent conclusions being made across studies and prevent pooling of the data. Further study with more relevant clinical endpoints and larger sample sizes is warranted.

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Authors and Affiliations

  1. Division of Surgical Oncology, University of Calgary Tom Baker Cancer Centre, 1331-29th Street NW, Calgary, Alberta, T2N 4N2, Canada

    Andrew McKay, Darby Cassidy, Francis Sutherland & Elijah Dixon

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  1. Andrew McKay
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  2. Darby Cassidy
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  3. Francis Sutherland
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McKay, A., Cassidy, D., Sutherland, F. et al. Clinical results of N-acetylcysteine after major hepatic surgery: a review. J Hepatobiliary Pancreat Surg 15, 473–478 (2008). https://doi.org/10.1007/s00534-007-1306-6

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  • DOI: https://doi.org/10.1007/s00534-007-1306-6

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