Postoperative course of functional and cellular variables in liver resection

The determination of total serum bile acids (BA) is a sensitive variable for detection of altered liver function. This study investigated the course of serum bile acids in 44 liver-resected patients with different factors possibly compromising liver function. These factors were 1) amount of resected parenchyma; 2) duration of intraoperative ischemia; and 3) patient's age. The course of BA was compared with that of transaminases, bilirubin, lactate, and NH3. Serum BA showed a course correlated to the amount of resected liver parenchyma and differentiated between groups with < or = 35% and > 35% resected parenchyma. Whereas BA were more accurate in paralleling the resected tissue in the first postoperative days, a rise of bilirubin indicated complications in the postoperative course. As BA did not increase in a case of pulmonary-induced multiorgan failure, the specificity of this variable for liver function is implied. Different amounts of resection could not be distinguished by determination of transaminases. Different ischemic periods did not result in significant differences in the postoperative course of BA or bilirubin. However, marked elevations of transaminases depending on the duration of hepatic inflow occlusion were seen. None of the traced variables were related to the patient's age.