A Clinical Study of Hyperkalemia During Hepatectomy

Takumi Fukumoto, Yonson Ku, Masahiro Yamamato

First Department of Surgery, Kobe University School of Medicine (Director: Prof. Yoichi Saitoh)

This study was undertaken to delineate the clinical features of hyperkalemia encountered during hepatectomy including the incidence, causative factors and therapeutic problems. Seven (11%) of 64 patients receiving hepatectomy had maximum levels of serum potassium more than 5 mEq/L during the operations. Three of these seven patients (hyperkalemic group) showed serum potassium levels higher than 6 mEq/L, which were accompanied by electrocardiographic abnormalities consisting of T wave elevation (2 cases) and ventricular fibrillation (1 case). In comparison of the preoperative factors, both serum GOT and GPT levels in the hyperkalemic group were significantly higher than those in the normokalemic (<5 mEq/L) group (p<0.05). However, the serum choline-esterase level, rate of retention of indocianine green, the indices reflecting renal function, and the rate of underlying cirrhosis did not differ between the two groups. Among the intraoperative factors, the cumulative hepatic vascular clamping time was significantly longer in the hyperkalemic group than that in the normokalemic group (p<0.05), whereas the operative time as well as the extent of resection did not affect the serum potassium level. We therefore conclude that preoperative elevations of serum transaminase levels, prolonged hepatic vascular clamping time and massive blood transfusion seem to be risk factors for hyperkalemia during hepatectomy.

Key words
hyperkalemia, hepatectomy, hepatic vascular clamping

Reprint requests
Yonson Ku First Department Surgery, Kobe University School of Medicine
7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650 JAPAN

Accepted
September 9, 1992

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