Hotta Tsukasa, Kobayashi Yasuhito, Taniguchi Katsutoshi, Johata Kiyofumi, Sahara Masaki, Ochiai Minoru, Watanabe Takashi, Tanimura Hiroshi
Department of Surgery, Wakayama Rosai Hospital, Wakayama, Japan.
Hepatogastroenterology. 2005 Jul-Aug;52(64):1211-5.
BACKGROUND/AIMS: 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.
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).
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.
TBA bile concentration obtained from C-tubes was a useful liver function indicator after hepatectomy.
背景/目的：为了预测肝切除术后可能导致死亡的肝衰竭，需要一种敏感且特异的肝功能指标。肝切除术后经胆囊管置管（C管）引流被认为有助于减少术后并发症。
比较了11例行C管引流的肝切除患者术后第2天（第2天）和术后第7天（第7天）的常规血清肝功能检查、C管胆汁中总胆汁酸（TBA）和总胆红素（T.Bil）的浓度水平。
在第2天至第7天血清肝功能检查指标改善时，胆汁中TBA浓度升高，而T.Bil浓度降低。在第7天，无肝硬化或ICGR15值低的患者胆汁中TBA浓度高于有肝硬化或ICGR15值高的患者，而两组患者胆汁中T.Bil浓度在第7天无显著差异，即胆汁中TBA浓度的测定可能是比T.Bil胆汁浓度更快、更准确的肝功能参数。
从C管获得的胆汁中TBA浓度是肝切除术后有用的肝功能指标。
