ALTERED BILIARY BILIRUBIN PROFILE IN PATIENTS WITH PERSISTENT HYPERBILIRUBINEMIA AFTER HEPATIC RESECTION - ANALYSIS OF BILE BILIRUBIN SUBFRACTIONS BY HIGH-PERFORMANCE LIQUID-CHROMATOGRAPHY

Subfractions of bilirubin in bile, obtained via biliary drainage tubes from 23 patients who had undergone radical surgery for bile duct canc er, were analysed by high-performance liquid chromatography for 14 day s after surgery. Five principal conjugated bilirubins were resolved: b ilirubin diglucuronide (BDG); bilirubin monoglucuronide monoglucoside (BGG); bilirubin monoglucuronide monoxyloside (BGX); and two isomers o f bilirubin monoglucuronide. After surgery, depression in concentratio n of BDG and elevation of EGG and BGX were found. These alterations we re of higher magnitude in patients who had undergone hepatectomy, and especially prolonged in patients with hyperbilirubinaemia. These resul ts suggest that the alteration in proportions of bilirubin conjugates might be a cause of hyperbilirubinaemia after hepatectomy.