Does a long pre-operative hospital stay before hepatectomy improve liver dysfunction in HCC patients with chronic liver disease?
OBJECTIVE
We retrospectively evaluated whether or not hepatic dysfunction improved in patients with chronic liver disease who had been waiting to undergo a hepatectomy after admission.


METHODS
Fifty-two hepatocellular carcinoma patients had been admitted for more than 2 weeks prior to undergoing a hepatectomy. They had a liver function test twice, at admission and just before surgery, during the hospitalization period. Twenty-six of them were histologically diagnosed as having chronic hepatitis while the remainder had liver cirrhosis. In the liver function test, the serum levels of albumin, total bilirubin, glutamic pyrubic transaminase (alanine transaminase), total cholesterol and the Child grade were examined.


RESULTS
First, including the pre-operative treatment cases for small tumors under angiography, the total bilirubin and transaminase levels improved in the chronic hepatitis patients with a statistically significant difference, but no difference was observed in the Child grade. In the examined cirrhotic patients, no significant difference was shown in the tests. Second, after excluding the pre-operative treatment cases, we performed the same investigation as that for chronic liver disease cases and only the transaminase level significantly improved.


CONCLUSIONS
A long pre-operative hospital stay might only by justified in patients with a high level of transaminase corresponding to chronic active hepatitis.
Ezaki
T
T
Department of Surgery, Iizuka Hospital, Japan.
Koyanagi
N
N
Toyomasu
T
T
Ikeda
Y
Y
Sugimachi
K
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000410:Alanine Transaminase / Q000097:blood; D000792:Angiography; D001663:Bilirubin / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000601:surgery*; D002784:Cholesterol / Q000097:blood; D002908:Chronic Disease; D005260:Female; D006498:Hepatectomy; D006521:Hepatitis, Chronic / Q000097:blood / Q000503:physiopathology*; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay; D008099:Liver / Q000503:physiopathology*; D008103:Liver Cirrhosis / Q000097:blood / Q000503:physiopathology*; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010343:Patient Admission; D011300:Preoperative Care; D012189:Retrospective Studies; D012709:Serum Albumin / Q000032:analysis
D012709:Serum Albumin; D002784:Cholesterol; D000410:Alanine Transaminase; D001663:Bilirubin