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

• Published in: Nippon Shokaki Geka Gakkai zasshi Vol. 26; no. 5; pp. 1227 - 1232
• Main Authors: Kawaida, Kouichi, Tanabe, Gen, Kurita, Kouichi, Hamanoue, Masahiro, Shirao, Kazusada, Kobayashi, Yasuyuki, Ueno, Shinichi, Mitsue, Shinji, Ogura, Yoshito, Yoshidome, Shinrou, Maenohara, Shigeho, Aikou, Takashi, Shimazu, Hisaaki
• Format: Journal Article
• Language: Japanese
• Published: The Japanese Society of Gastroenterological Surgery 1993
• Subjects: hemopurification; hepatectomy; hyperbilirubinemia; plasma absorption for hyperbilirubinemia; plasma exchange for hyperbilirubinemia
• ISSN: 0386-9768; 1348-9372
• DOI: 10.5833/jjgs.26.1227

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 inthe 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.