POSTOPERATIVE COURSE OF FUNCTIONAL AND CELLULAR VARIABLES IN LIVER RESECTION

The determination of total serum bile acids (BA) is a sensitive variab le for detection of altered liver function. This study investigated th e course of serum bile acids in 44 liver-resected patients with differ ent factors possibly compromising liver function. These factors were 1 ) amount of resected parenchyma; 2) duration of intraoperative ischemi a; and 3) patient's age. The course of BA was compared with that of tr ansaminases, bilirubin, lactate, and NH3, Serum BA showed a course cor related to the amount of resected liver parenchyma and differentiated between groups with less-than-or-equal-to 35% and >35% resected parenc hyma. Whereas BA were more accurate in paralleling the resected tissue in the first postoperative days, a rise of bilirubin indicated compli cations in the postoperative course. As BA did not increase in a case of pulmonary-induced multiorgan failure, the specificity of this varia ble for liver function is implied. Different amounts of resection coul d not be distinguished by determination of transaminases. Different is chemic periods did not result in significant differences in the postop erative course of BA or bilirubin. However, marked elevations of trans aminases depending on the duration of hepatic inflow occlusion were se en. None of the traced variables were related to the patient's age.