Usefulness of Monitoring Serum Alkaline Phosphatase Level as a Parameter of Hepatic Regeneration after Massive Hepatectomy

Chiaki Yasui, Naoki Yamanaka, Eizo Okamoto

First Department of Surgery, Hyogo College of Medicine

The importance of monitoring alkaline phosphatase as a parameter of the posthepatectomy course was studied in the 46 massively hepatectomized patients with normal (17 cases), cirrhotic (21 cases) or obstructive jaundiced (8 cases) livers. A total bilirubin level over 5.0 mg/dl in the postoperative course was defined as hepatic failure. The alkaline phosphatase level in uneventful cases reached the bottom just after the operation and subsequently increased with decreasing total bilirubin level. In the early postoperative period, the rate of increas in serum alkaline phsphatase was higher in normal liver than in the other groups. No correlation between the prothrombin time and the alkaline phosphatase level was found in the postoperative course. In contrast, in the patients with progressive hepatic failure, the alkaline phosphatase level decreased and remained lower level. These findings lead us to the conclusion that after massive hepatectomy, monitoring of serum alkaline phsphatase is useful in predicting bile secretion capacity and the regenerative process in the remnant liver.

Key words
alkaline phosphatase, liver regeneration, massive hepatectomy, prognostic factor

Reprint requests
Chiaki Yasui First Department of Surgery, Hyogo College of Medicine
1-1 Mukogawa, Nishinomiya, 663 JAPAN

Accepted
January 10, 1996

To read the PDF file you will need Abobe Reader installed on your computer.