Figure 3.

The effect of intraoperative liver cooling on blood glucose levels after major hepatectomy is performed under VIO. Patients scheduled for a right hemihepatectomy were randomized between intermittent VIO (control) or continuous VIO with liver cooling to a temperature of 28°C using IHP according to Reiniers et al. (7) (IHP, see Liver Resection). Blood glucose levels (y axis) were obtained by routine blood gas analysis and plotted as a function of reperfusion time (x axis). Values are displayed as mean ± standard error of the mean for nine IHP patients and five control patients. At the end of ischemia, blood glucose levels were higher in the control group than in patients treated with IHP (Mann-Whitney U test). The comparable glucose levels during the reperfusion phase are explained by the start of insulin therapy immediately after surgery. All study protocols (NCT01499979) were approved by the institutional review board.