Indication and Effect of Hemopurification for Hyperbilirubinemia after Hepatectomy for Hepatocellular Carcinoma

Kouichi Kawaida, Gen Tanabe, Kouichi Kurita, Masahiro Hamanoue, Kazusada Shirao, Yasuyuki Kobayashi, Shinichi Ueno, Shinji Mitsue, Yoshito Ogura, Shinrou Yoshidome, Shigeho Maenohara, Takashi Aikou, Hisaaki Shimazu

First Department of Surgery, Kagoshima University School of Medicine

Thirty-nine of 73 patients after hepatectomy for hepatocellular carcinoma were associated with postoperative hyperbilirubinemia. Preoperative suppression of protein synthesis, massive perioperative bleeding and postoperative intraabdominal infection probably participated in the occurrence of postoperative hyperbilirubinemia. Hemopurification (HP) for hyperbilirubinenia were conducted on 12 patients among them. The HP procedure included plasma exchange (PE) and plasma absorption (PA). Five patients survived, but 7 died within 2 months after HP. In the survived cases by HP, preoperative abilities of protein synthesis were better than those in the non-survived cases. Furthermore, perioperative bleeding was less in the survived cases. Greater improvement in serum total bilirubin and hepaplastin test results was obtained by PE than by PA. HP is particularly recommended in the early phase of hyperbilirubinemia when serum total bilirubin raises more than 5 mg/dl.

Key words
hemopurification, hyperbilirubinemia, hepatectomy, plasma exchange for hyperbilirubinemia, plasma absorption for hyperbilirubinemia

Reprint requests
Kouichi Kawaida First Department of Surgery, Kagoshima University School of Medicine
8-35-1 Sakuragaoka, Kagoshima, 890 JAPAN

Accepted
January 13, 1993

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