The Usefulness of Hyperbaric Oxygen Therapy for Prolonged Jaundice after Hepatectomy

Seiji Hosaka, Tatsuya Tsuji, Katsuhiko Inoue, Keiichiro Kanemitsu, Takehisa Hiraoka, Nobuo Kitamura and Kazufumi Okamoto^*

First Department of Surgery, Kumamoto University Medical School
^*Division of Intensive and Critical Care Medicine

We present three cases treated with hyperbaric oxygenation therapy (HBO) for prolonged jaundice after hepatectomy. Case 1: A 65-year-old man underwent right lobectomy for cancer of the gallbladder. After the operation, jaundice was prolonged and his total bilirubin rose to 18.1 mg/dl. HBO was performed thirteen times, and his total bilirubin decreased to 5.4 mg/dl. Case 2: A 69-year-old man underwent right lobectomy for bile duct cancer. His total bilirubin increased to 19. 3 mg/dl. HBO was performed sixteen times and his total bilirubin decreased to 3.3 mg/dl. Case 3: A 64-year-old man underwent electrohydraulic lithotripsy for his remnant intrahepatic stone after hepatectomy of his cirrhotic liver. His total bilirubin increased with each lithotripsy treatment. HBO was commenced and his total bilirubin temporarily decreased to 11.5 mg/dl from 21.1 mg/dl, but finally increased again due to severe cholangitis, which caused fatal liver failure. Therefore HBO was not effective for jaundice in the patient with a cirrhotic liver and without a functional reserve. However, prolonged jaundice after hepatectomy of a non-cirrhotic liver was successfully treated with HBO.

Key words
hyperbaric oxygenation therapy, hepatectomy, jaundice

Reprint requests
Seiji Hosaka First Department of Surgery, Kumamoto University Medical School 1-1-1 Honjo, Kumamoto, 860-0811 JAPAN

Accepted
November 13, 1998

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