The Effect of Somatostatin for Treatment of Post Hepatectomy Liver Failure (PHLF)

Study Overview
=================
Brief Summary
-----------------
Post hepatectomy liver failure (PHLF) is a serious medical problem could lead to patient death, however, definite treatment strategy has not been established. The liver is a regenerating organ and the possibility of PHLF could be reduced when the appropriate liver regeneration is guaranteed. Portal flow has known to be important during liver regeneration. Low portal flow cannot induce proper regeneration, contrary, excessive flow increase shear stress in the hepatic sinusoid resulting liver failure. Various medications has been used in malignant liver cirrhosis to reduce portal pressure. Among them, somatostatin has been used modulating portal flow reducing portal and sinusoidal pressure. In this study, the investigators administrate somatostatin at a rate of 3.5ug/kg/hour to PHLF patients (prothrombin time < 50% and serum total bilirubin > 2.9mg/dl after liver resection) until recovery from liver failure. For assessment of the recovery of liver failure, the investigators evaluate aspartate transaminase (AST), alanine transaminase (ALT), serum total bilirubin and prothrombin time periodically after administration of medication.

Official Title
-----------------
The Effect of Somatostatin for Treatment of Post Hepatectomy Liver Failure (PHLF)

Conditions
-----------------
Liver Failure

Intervention / Treatment
-----------------
* Drug: Somatostatin


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Patients with PHLF without regard primary disease. Ability to provide written informed consent Exclusion Criteria: Concomitant surgery for another intraabdominal organs. Severe renal disease requiring dialysis. Patients with coagulation disorders or taking warfarin. Immunosuppressed patients or the patients with autoimmune disorders. Women with pregnant, breast-feeding. Hypersensitivity to somatostatin. Patients treated with other investigational product within 30 days at the consents are obtained. Patients with a significantly reduced cognitive abilities. Not eligible to participate for study at the discretion of investigator.

Ages Eligible for Study
-----------------
Minimum Age: 18 Years
Maximum Age: 80 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: somatostatin group<br>The investigators administrate somatostatin at a rate of 3.5ug/kg/hour to PHLF patients (prothrombin time < 50% and serum total bilirubin > 2.9mg/dl after liver resection) until recovery from liver failure. | Drug: Somatostatin<br> <br> |

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| in hospital mortality |  | up to 4 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Complication rate |  | up to 4 weeks | 
| Time to recovery from PHLF (days) |  | up to 4 weeks |