Postoperative biochemical liver function after major hepatic resection in children.
OBJECTIVE
There are no detailed reports of the profile of biochemical liver function tests (LFTs) after partial hepatectomy in children. The study aims to establish normal profiles of standard LFTs after major liver resection in noncirrhotic children; the effects of preoperative chemotherapy were also analyzed.


METHODS
Clinical and biochemical data were collected from a consecutive series of children who had undergone a primary major liver resection for a hepatic tumor. Chemotherapy details were recorded. Children who had more than 4 liver segments resected were compared with those undergoing lesser resections. Those with and without preoperative chemotherapy were also compared.


RESULTS
A total of 22 children underwent major liver resection at a median age of 24 months (range, 2 weeks to 16 years). Fifteen received preoperative chemotherapy. Peak derangements in all standard LFTs occurred on day 1 to day 2 postoperatively. Normal plasma levels of bilirubin and albumin were present by day 5, international normalized ratio and alkaline phosphatase by day 7, and alanine aminotransferase by 1 to 2 weeks. Peak alanine aminotransferase and international normalized ratio values tended to be higher in children having more extensive liver resections. Preoperative chemotherapy given up to 3 weeks before surgery had no major effect on LFT recovery profiles. Hypophosphatemia was maximal on day 2.


CONCLUSIONS
Postoperative LFTs showed a more rapid resolution than typically seen after partial hepatectomy in adults. Preoperative chemotherapy had no major effects on postresection LFT profiles.
Needham
Paul
P
Department of Surgery, St James's University Hospital, Leeds LS9 7TF, UK.
Dasgupta
Dowmitra
D
Davies
John
J
Stringer
Mark D
MD
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D006498:Hepatectomy; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008099:Liver / Q000378:metabolism* / Q000601:surgery*; D008107:Liver Diseases / Q000188:drug therapy / Q000601:surgery*; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000188:drug therapy / Q000601:surgery*; D011184:Postoperative Period; D012016:Reference Values; D012189:Retrospective Studies