Liver functional analysis by total bile acid level of C-tube bile after hepatectomy.
OBJECTIVE
In order to predict liver failure which can lead to death after hepatectomy, a sensitive and specific indicator is needed for liver function. Transcystic duct tube (C-tube) drainage after hepatectomy is thought to be useful in decreasing postoperative complications.


METHODS
Conventional serum liver function tests, and total bile acid (TBA) and total bilirubin (T.Bil) concentration levels of bile from a C-tube in 11 hepatectomized patients who underwent C-tube drainage were compared on postoperative day 2 (Day 2) and postoperative day 7 (Day 7).


RESULTS
When serum liver function tests were improving between Day 2 and Day 7, the TBA concentration in bile was increasing in contrast to a decreasing T.Bil concentration. On Day 7, TBA concentrations in the bile in patients without liver cirrhosis or with low ICGR15 values were higher than those in patients with liver cirrhosis or with high ICGR15 values, whereas there were no significant differences between T.Bil bile concentrations in the two groups on Day 7, that is, the measurement of TBA bile concentration might be a faster and more accurate parameter for liver function than that of T.Bil bile concentration.


CONCLUSIONS
TBA bile concentration obtained from C-tubes was a useful liver function indicator after hepatectomy.
Department of Surgery, Wakayama Rosai Hospital, Wakayama, Japan. hotta@naxnet.or.jp
Tsukasa
T
Hotta
Yasuhito
Y
Kobayashi
Katsutoshi
K
Taniguchi
Kiyofumi
K
Johata
Masaki
M
Sahara
Minoru
M
Ochiai
Takashi
T
Watanabe
Hiroshi
H
Tanimura
D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D000469:Alkaline Phosphatase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D001647:Bile Acids and Salts / Q000378:metabolism*; D001663:Bilirubin / Q000378:metabolism*; D004322:Drainage; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy; D006801:Humans; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000378:metabolism* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D013997:Time Factors
D001647:Bile Acids and Salts; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D000469:Alkaline Phosphatase; D001663:Bilirubin