Level of total bilirubin in the bile of the future remnant liver of patients with obstructive jaundice undergoing hepatectomy predicts postoperative liver failure

Abstract

Background We investigated whether the daily level of total bilirubin in the bile (LTB) excreted from the future remnant liver (FRL) can predict post‐hepatectomy liver failure (PHLF) in patients with obstructive jaundice undergoing hepatectomy. Methods Seventy‐four patients who underwent biliary drainage and collection of bile juice from the FRL before undergoing right hepatectomy or right/left trisectionectomy with bile duct resection were included. The LTB from the FRL (mg/d) was calculated as the volume of the bile (dL) per day multiplied by the density of total bilirubin in the bile (mg/dL). We compared patients' characteristics with or without PHLF, which was defined as the total serum bilirubin level remaining >10 mg/dL after postoperative day 10. Then, pre‐ and intraoperative factors related to PHLF were examined. Results PHLF was observed in six patients. LTB was significantly lower in the PHLF group. The LTB cut‐off value for predicting PHLF, as determined using the receiver operating characteristic curve, was 56 mg/d. On multivariate analysis, LTB was found to be an independent risk factor for PHLF (P = .01, OR 35.88). Conclusions LTB may be a potential functional assessment in jaundiced patients before right hepatectomy and right/left trisectionectomy.

Magnetic Resonance Cholangiopancreatography to Evaluate Improvement Effect of FXR Regulating Bile Acid on Hepatocellular Carcinoma with Obstructive Jaundice

“…Studies have shown that elevated transaminases and serum bilirubin may present with obstructive jaundice when the left and right hepatic ducts are obstructed at the same time or the common hepatic duct is obstructed, and patients may present with only elevated transaminases and normal serum total bilirubin when one hepatic duct is obstructed alone [ 18 ]. The detection results showed that serum AST, ALT, TBIL, Na + , and K + contents in the control group were 118.4 ± 6.2 U/L, 55.7 ± 1.2 U/L, 1.9 ± 0.4 μ mol/L, 135.74 ± 4.76 mmol/L, and 4.14 ± 0.52 mmol/L, respectively; the serum AST content in the study group before treatment was 146.3 ± 9.7 U/L, significantly higher than that in the control group, and the difference had a statistical significance ( P < 0.05); after treatment, the serum AST content was 123.5 ± 4.9 U/L, significantly lower than that before treatment, and the difference had statistical significance ( P < 0.05); the TBIL content was 1.8 ± 0.3 μ mol/L, significantly lower than 2.2 ± 0.5 μ mol/L before treatment, and the difference had statistical significance ( P < 0.05).…”

Neutrophils’ functional activity in patients with mechanical jaundice and different levels of bilirubin

“…The chemiluminescence (ChL) method allows the analysis of the features of a respiratory burst in spontaneous and induced states in various diseases 14 . An extremely important indicator for patients with MJ is their bilirubin level, which plays a crucial role in the disease progression 15 . It has been previously shown that the increased levels of serum bilirubin may be the reason for the bactericidal activity of neutrophils' impairment in patients with hyperbilirubinemia 16,17 .…”