Background
We investigated whether the daily level of total bilirubin in the bile (LTB) excreted from the future remnant liver (FRL) can predict post‐hepatectomy liver failure (PHLF) in patients with obstructive jaundice undergoing hepatectomy.
Methods
Seventy‐four patients who underwent biliary drainage and collection of bile juice from the FRL before undergoing right hepatectomy or right/left trisectionectomy with bile duct resection were included. The LTB from the FRL (mg/d) was calculated as the volume of the bile (dL) per day multiplied by the density of total bilirubin in the bile (mg/dL). We compared patients' characteristics with or without PHLF, which was defined as the total serum bilirubin level remaining >10 mg/dL after postoperative day 10. Then, pre‐ and intraoperative factors related to PHLF were examined.
Results
PHLF was observed in six patients. LTB was significantly lower in the PHLF group. The LTB cut‐off value for predicting PHLF, as determined using the receiver operating characteristic curve, was 56 mg/d. On multivariate analysis, LTB was found to be an independent risk factor for PHLF (P = .01, OR 35.88).
Conclusions
LTB may be a potential functional assessment in jaundiced patients before right hepatectomy and right/left trisectionectomy.