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Indicators of liver excretory function in patients undergoing biliary decompression for obstructive jaundice
C Y Chen1, S C Shiesh, X Z Lin
1Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan.
Hepato-Gastroenterology
|July 31, 1998
Summary
Clinical factors like bile acid excretion and bilirubin levels on day 3 can predict liver function recovery after biliary drainage for obstructive jaundice. Poor recovery is indicated by decreased bile acid excretion and slower bilirubin reduction.
Area of Science:
- Hepatology
- Gastroenterology
- Biochemistry
Background:
- Obstructive jaundice recovery varies with obstruction severity and duration.
- Clinical factors for monitoring liver function recovery post-biliary drainage are needed.
Purpose of the Study:
- To identify clinical factors predicting liver function recovery after biliary drainage.
- To correlate these factors with the indocyanine green retention test (ICG R15).
Main Methods:
- Collected serum and bile from 12 patients undergoing biliary drainage.
- Assessed liver function using indocyanine green retention test (ICG R15) before and 6 days after drainage.
- Compared biochemical data and ICG R15 reduction ratios between good and poor recovery groups.
Main Results:
- Poor recovery group showed less bile acid excretion and slower bilirubin reduction on day 3.
- Good recovery group had higher bile acid excretion and faster bilirubin reduction.
- ICG R15 reduction ratio correlated significantly with bilirubin reduction, bile volume, and bile acid excretion on day 3.
Conclusions:
- Decreased bile acid excretion and slow bilirubin reduction suggest severe liver damage.
- These indicators, resulting from prolonged obstruction, may predict a long and poor recovery.
- Choleresis indicates ductular cell hyperplasia, a sequela of prolonged obstruction.