INCREASED URINARY-EXCRETION OF BILIRUBIN METABOLITES IN ASSOCIATION WITH HYPERBILIRUBINEMIA AFTER ESOPHAGECTOMY

This study was conducted to investigate the rationale for postoperativ e hyperbilirubinemia after major surgery. The serum bilirubin values a nd urinary excretion of bilirubin metabolites (BM) were monitored in 1 1 patients who underwent esophagectomy via right thoracotomy for esoph ageal cancer, Both the serum bilirubin values and the urinary excretio n of BM increased postoperatively in all patients. The maximum serum b ilirubin level in four patients,vith septic complications, two of whom developed pneumonia and two, anastomotic leakage (group A), was signi ficantly higher at 5.25 +/- 4.16 mg/dl than in the remaining patients without septic complications (group B), at 2.11 +/- 0.07 mg/dl, The pe ak value of urinary BM was 99.5 +/- 88.2 mu mol/day in group A and 23. 5 +/- 26.7 mu mol/day in group B, The correlation between the level of serum bilirubin and urinary BM excretion was found to be significant, Thus, the metabolism of bilirubin was increased by extensive surgical stress and septic insult.