Serum alkaline phosphatase after extensive liver resection: a study in patients with biliary tract carcinoma.
OBJECTIVE
To clarify a correlation between serum alkaline phosphatase (ALP) levels and liver function and regeneration after major hepatectomy.


METHODS
Post-operative changes in serum ALP levels were retrospectively examined in 91 non-cirrhotic patients with biliary tract carcinoma who underwent right hepatic lobectomy or more extensive liver resection. In addition, changes in liver volume after resection were assessed in 31 patients who underwent computed tomography before surgery and within 1 month after resection.


RESULTS
Serum ALP levels reached its nadir on post-operative day 1, followed by a gradual increase until post-operative day 28. In patients with post-hepatectomy liver failure (n = 32), serum ALP levels were significantly lower on days 1, 7, 10, 14, 21, and 28 after resection than in those without such failure (n = 59). Unexpectedly, the volumetric study of the liver showed no significant difference between the two groups in the remnant liver volume after resection.


CONCLUSIONS
Serum ALP levels can function as an indicator of liver function after hepatectomy, but not reflect morphological regeneration of the liver. Thus, increased ALP levels after hepatectomy may not reflect the cellular proliferation process itself.
Nagino
M
M
First Department of Surgery, Nagoya University School of Medicine, Japan.
Nimura
Y
Y
Kamiya
J
J
Kanai
M
M
Uesaka
K
K
Hayakawa
N
N
Yamamoto
H
H
D000328:Adult; D000368:Aged; D000469:Alkaline Phosphatase / Q000097:blood*; D001650:Bile Duct Neoplasms / Q000601:surgery*; D001653:Bile Ducts, Intrahepatic / Q000601:surgery; D018281:Cholangiocarcinoma / Q000601:surgery*; D005260:Female; D005706:Gallbladder Neoplasms / Q000601:surgery*; D006498:Hepatectomy; D006801:Humans; D017093:Liver Failure / Q000175:diagnosis* / Q000201:enzymology; D008111:Liver Function Tests; D008115:Liver Regeneration / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis* / Q000201:enzymology; D011379:Prognosis
D000469:Alkaline Phosphatase