Bile changes after liver surgery: experimental and clinical lessons for future applications.
BACKGROUND
The aim of this review is to summarize the available evidence for changes in bile composition following liver surgery and assess their use in predicting post-operative complications.


METHODS
A literature search was undertaken for all studies focusing on bile composition, bile volume and analysis. Articles were selected from MEDLINE, Embase and the Cochrane Central Register of Controlled Trials databases up to May 2009.


RESULTS
Low values of pre-operative bilirubin diglucuronide predict reduced post-operative liver function and the occurrence of jaundice. Low concentrations of hepatocyte growth factor and interleukin-6 in bile following surgery are associated with the subsequent development of liver failure and are probably surrogate markers for situations where the resultant hepatic regeneration is inadequate.


CONCLUSIONS
Analysis of the composition and quality of bile is probably underused as a tool for the pre-operative screening and early post-operative monitoring of patients at high risk of developing liver failure following major hepatobiliary procedures.
Department of Hepatobiliary and Pancreatic Surgery, University Hospitals of Leicester, Leicester, UK. ggravante@hotmail.com
Gianpiero
G
Gravante
Timothy
T
Knowles
Seok Ling
SL
Ong
Omer
O
Al-Taan
Matthew
M
Metcalfe
Ashley R
AR
Dennison
David M
DM
Lloyd
D001646:Bile / Q000737:chemistry*; D001663:Bilirubin / Q000031:analogs & derivatives / Q000032:analysis; D017228:Hepatocyte Growth Factor / Q000032:analysis; D006801:Humans; D015850:Interleukin-6 / Q000032:analysis; D007565:Jaundice / Q000209:etiology; D008099:Liver / Q000502:physiology / Q000601:surgery*; D017093:Liver Failure / Q000175:diagnosis; D008115:Liver Regeneration / Q000502:physiology; D008991:Monitoring, Physiologic; D011184:Postoperative Period
D015850:Interleukin-6; C019270:bilirubin diglucuronide; D017228:Hepatocyte Growth Factor; D001663:Bilirubin