Effect of N-acetylcysteine on liver and kidney function tests after surgical bypass in obstructive jaundice: A randomized controlled trial.

Farzad Kakaei, Masoud Fasihi, Shahriar Hashemzadeh, Sina Zarrintan, Samad Beheshtirouy, Touraj Asvadi-Kermani, Kowsar Tarvirdizadeh, Seyfollah Rezaei, Behnam Sanei

Journal: Asian journal of surgery 2020;43(1):322-329

PMID: 31280997

Abstract

BACKGROUND

It has been shown that N-acetylcysteine may be useful in correcting postoperative hepatic and renal function in many pathological conditions. The present study aimed to examine the effect of N-acetylcysteine on liver and kidney function tests after surgical bypass in patients with obstructive jaundice.

METHODS

& Materials: A total of 30 patients with obstructive jaundice who were candidates for bypass surgery were enrolled in this randomized clinical trial. In the case group, intravenous N-acetylcysteine (200 mg/kg per hour in the first 8 h, followed by 100 mg/kg per hour for another 16 h, the same dose for another 24 h) was administered postoperatively. Liver and renal function tests (serum AST, ALT, ALP, GGT, bilirubin, and creatinine) were compared between two groups, as well as duration of hospitalization and ICU stay.

RESULTS

Postoperatively, decrease in mean serum AST (p = 0.01), ALT (p = 0.02), ALP (p = 0.01), GGT (p = 0.04) and bilirubin (total, p = 0.02, direct, p = 0.01) levels compared to the preoperative values was significantly more among cases compared to those in controls. Changes in serum creatinine, however, did not differ significantly between two groups (p = 0.18). Hospital and ICU stays were also not different between two study groups (p = 0.27 and p = 0.94 respectively).

CONCLUSION

On the basis of our findings, intravenous N-acetylcysteine in patients with obstructive jaundice could significantly preserve liver function after bypass surgery. Effect of this medication on renal function; however, was not statistically significant.

TRIAL REGISTRATION

Iranian Registry of Clinical Trial: IRCT2016041016473N7.

Copyright © 2019. Published by Elsevier Taiwan LLC.

Address: Department of General Surgery, Tabriz University of Medical Sciences, Tabriz, Iran; Section of Visceral Transplantation, Imam Reza Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.; Department of General Surgery, Tabriz University of Medical Sciences, Tabriz, Iran.; Department of General Surgery, Tabriz University of Medical Sciences, Tabriz, Iran; Department of Cardiothoracic Surgery, Tabriz University of Medical Sciences, Tabriz, Iran.; Division of Vascular & Endovascular Surgery, Department of General & Vascular Surgery, Shohada-Tajrish Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Electronic address: [email protected].; Department of Cardiothoracic Surgery, Tabriz University of Medical Sciences, Tabriz, Iran.; Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.; Department of General Surgery, Imam Khomeini Hospital, Urmia University of Medical Sciences, Urmia, Iran.; Section of Kidney Transplantation, School of Medicine, Al-Zahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.
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