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Bile changes after liver surgery: experimental and clinical lessons for future applications
Gianpiero Gravante1, Timothy Knowles, Seok Ling Ong
1Department of Hepatobiliary and Pancreatic Surgery, University Hospitals of Leicester, Leicester, UK. ggravante@hotmail.com
Digestive Surgery
|November 11, 2010
Summary
Analyzing bile composition after liver surgery can predict complications. Low pre-operative bilirubin diglucuronide indicates poor liver function and jaundice risk, while low post-operative growth factors signal potential liver failure.
Area of Science:
- Hepatobiliary Surgery
- Gastroenterology
- Biochemistry
Background:
- Liver surgery can alter bile composition.
- Changes in bile may predict post-operative complications.
Purpose of the Study:
- To review evidence on bile composition changes after liver surgery.
- To assess bile analysis for predicting post-operative complications.
Main Methods:
- Literature search of MEDLINE, Embase, and Cochrane databases up to May 2009.
- Included studies on bile composition, volume, and analysis.
Main Results:
- Low pre-operative bilirubin diglucuronide predicts reduced liver function and jaundice.
- Low post-operative hepatocyte growth factor and interleukin-6 indicate risk of liver failure.
- These factors may be surrogate markers for inadequate hepatic regeneration.
Conclusions:
- Bile analysis is underutilized for pre-operative screening and post-operative monitoring.
- Assessing bile composition can identify high-risk patients for liver failure after hepatobiliary procedures.
