Evaluation of functional liver reserve in patients with obstructive jaundice undergoing hepatectomy

BACKGROUND/AIMS: In hepatectomy in patients with obstructive jaundice, correct evaluation of the functional liver reserve is sometimes difficult. This study examined whether the preoperative level of total bilirubin in the bile from a predicted remnant liver can be used as a predictor for safe hepatectomy in such patients. METHODOLOGY: Twenty consecutive patients with jaundice who underwent major hepatectomy and in whom all bile from the predicted remnant liver could be collected were included in this study. The level of total bilirubin in the bile was calculated by multiplying bile volume and density obtained by percutaneous transhepatic biliary drainage. Patients were divided into two groups, with (group 1) and without postoperative death due to liver failure (group 2). RESULTS: The level of total bilirubin in the bile from the predicted remnant liver was lower in group 1 than in group 2. Patients did not die of postoperative liver failure if the level of total bilirubin in the bile was maintained, even if the bile volume or density were low. CONCLUSIONS: The preoperative level of total bilirubin in the bile from the predicted remnant liver can be used as a predictor for safe hepatectomy in patients with obstructive jaundice.