Bile acid profile and decrement rate of serum total bilirubin after biliary drainage

1990 ◽  
Vol 25 (6) ◽  
pp. 732-738 ◽  
Author(s):  
Tomoo Kosuge ◽  
Tomoe Beppu ◽  
Shigeo Iwasaki ◽  
Tohru Itoh ◽  
Yasuo Idezuki
Keyword(s):  
Bile Acid ◽  
Biliary Drainage ◽  
Total Bilirubin ◽  
Serum Total Bilirubin ◽  
Decrement Rate

scholarly journals Predictive Power of Preoperative Serum Total Bilirubin for the Outcomes Following Pancreaticoduodenectomy

2020 ◽  
Vol 13 (11) ◽  
Author(s):  
Sara Saeidi Shahri ◽  
Mohsen Aliakbarian ◽  
Lida Jarahi
Keyword(s):  
Logistic Regression ◽  
Bilirubin Level ◽  
Biliary Drainage ◽  
Predictive Power ◽  
Total Bilirubin ◽  
Total Bilirubin Level ◽  
Serum Total Bilirubin ◽  
Significant Variable ◽  
Preoperative Serum ◽  
Significant Difference

Background: The high levels of bilirubin in patients with periampullary cancers may increase the morbidity or mortality after curative surgery. Objectives: We aimed at evaluating the predictive power of preoperative serum total bilirubin for the outcomes after pancreaticoduodenectomy (PD) in resectable periampullary cancers. Methods: The data of 80 patients, who had undergone PD, were retrospectively analyzed. Regarding the preoperative bilirubin, we opted for 20 mg/dL as the cut-off value to divide patients into two groups to be subjected to simple and multiple logistic regression. Results: A total of 80 patients with a mean age of 54.90 ± 14.33 years underwent PD. The median preoperative bilirubin level was 4.7 mg/dL and the majority of cases (88.8%) had bilirubin < 20 mg/dL. While there was no significant difference in the mortality between bilirubin groups (P = 0.266), bilirubin≥20 mg/dL remarkably increased the postoperative morbidity (P = 0.012, Odds ratio = 3.04); 57.5% of cases underwent biliary drainage before surgery, which did not impact the mortality and morbidity. Multiple analysis by a logistic regression model disclosed that the only statistically significant variable for mortality was the total operative time (P = 0.038) and among all factors, total bilirubin level was the only independent predictor for the morbidity status (P = 0.009). Conclusions: This study suggested that preoperative biliary drainage should only be limited to patients with high bilirubin levels (≥ 20 mg/dL) or expected delayed surgeries.

Extracorporeal Albumin Dialysis in Liver Failure with MARS and SPAD: A Randomized Crossover Trial

2021 ◽  
pp. 1-8
Author(s):  
Grégoire Wallon ◽  
Cécile Guth ◽  
Céline Guichon ◽  
Sylvie Thevenon ◽  
Mathieu Gazon ◽  
...  
Keyword(s):  
Bile Acid ◽  
Liver Failure ◽  
Total Bilirubin ◽  
Surgical Intensive Care Unit ◽  
Factor V ◽  
Albumin Dialysis ◽  
Surgical Intensive Care ◽  
Dialysate Flow ◽  
Molecular Adsorbent Recirculating System ◽  
Conjugated Bilirubin

<b><i>Introduction:</i></b> Liver failure is associated with hepatic and extrahepatic organ failure leading to a high short-term mortality rate. Extracorporeal albumin dialysis (ECAD) aims to reduce albumin-bound toxins accumulated during liver failure. ECAD detoxifies blood using albumin dialysis through an artificial semipermeable membrane with recirculation (molecular adsorbent recirculating system, MARS) or without (single-pass albumin dialysis, SPAD). <b><i>Methods:</i></b> We performed a randomized crossover open trial in a surgical intensive care unit. The primary outcome of the study was total bilirubin reduction during MARS and during SPAD therapies. The secondary outcomes were conjugated bilirubin and bile acid level reduction during MARS and SPAD sessions and tolerance of dialysis system devices. Inclusion criteria were adult patients presenting liver failure with factor V activity &#x3c;50% associated with bilirubin ≥250 μmol/L and a complication (either hepatic encephalopathy, severe pruritus, or hepatorenal syndrome). For MARS and SPAD, the dialysis flow rate was equal to 1,000 mL/h. <b><i>Results:</i></b> Twenty crossovers have been performed. Baseline biochemical characteristics (bilirubin, ammonia, bile acids, creatinine, and urea) were not statistically different between MARS and SPAD. Both ECAD have led to a significant reduction in total bilirubin (−83 ± 67 μmol/L after MARS; −122 ± 118 μmol/L after SPAD session), conjugated bilirubin (−82 ± 61 μmol/L after MARS; −105 ± 96 μmol/L after SPAD session), and bile acid levels (−64 ± 75 μmol/L after MARS; −56 ± 56 μmol/L after SPAD session), all nondifferent comparing MARS to SPAD. <b><i>Conclusion:</i></b> A simple-to-perform SPAD therapy with equal to MARS dialysate flow parameters provides the same efficacy in bilirubin and bile acid removal. However, clinically relevant endpoints have to be evaluated in randomized trials to compare MARS and SPAD therapies and to define the place of SPAD in the liver failure care program.

scholarly journals Clinical Significance of Gamma-Glutamyltranspeptidase Combined with Carbohydrate-Deficient Transferrin for the Assessment of Excessive Alcohol Consumption in Patients with Alcoholic Cirrhosis

Medicines ◽  
2021 ◽  
Vol 8 (7) ◽  
pp. 39
Author(s):  
Akihiko Shibamoto ◽  
Tadashi Namisaki ◽  
Junya Suzuki ◽  
Takahiro Kubo ◽  
Satoshi Iwai ◽  
...  
Keyword(s):  
Alcohol Consumption ◽  
Biological Markers ◽  
Prediction Accuracy ◽  
Total Bilirubin ◽  
Alcoholic Cirrhosis ◽  
Serum Total Bilirubin ◽  
Excessive Alcohol Consumption ◽  
Significant Difference ◽  
Carbohydrate Deficient Transferrin ◽  
Excessive Alcohol

: Background: This study aimed to compare the diagnostic performance of carbohydrate-deficient transferrin (CDT) and gamma-glutamyltranspeptidase (γ-GTP) to assess the single and combined benefits of these biological markers for the detection of chronic excessive alcohol consumption in patients with alcoholic cirrhosis. Methods: Biological markers were determined in blood samples from patients with alcoholic cirrhosis (drinking group, n = 35; nondrinking group, n = 81). The prediction accuracy of %CDT alone, γ-GTP alone, and their combination for the detection of excessive alcohol consumption was determined in patients with alcoholic cirrhosis. Results: Serum total bilirubin, alanine aminotransferase, aspartate aminotransferase, γ-GTP, and alkaline phosphatase levels and %CDT were significantly higher and serum albumin levels were significantly lower in the drinking group than in the nondrinking group. The combination of %CDT and γ-GTP compared with %CDT or γ-GTP alone showed a higher prediction accuracy. The combination of %CDT and γ-GTP exhibited a higher specificity than γ-GTP alone. However, in terms of sensitivity, no significant difference was found between single or combined markers. Conclusions: The combination of %CDT and γ-GTP is considered a useful biomarker of chronic excessive alcohol consumption in patients with alcoholic cirrhosis.

Child-Pugh classification and serum total bilirubin levels are prognostic factors following tips

2000 ◽  
Vol 118 (4) ◽  
pp. A1454
Author(s):  
Zeki Karasu ◽  
Ahmet O. Gurakar ◽  
Ahmad S. Jazzar ◽  
Barbara Kerwin ◽  
Saadettin Hulagu ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Total Bilirubin ◽  
Serum Total Bilirubin

scholarly journals Association of Serum Total Bilirubin with Serum High Sensitivity C-reactive Protein in Middle-aged Men

2011 ◽  
Vol 32 (6) ◽  
pp. 327 ◽  
Author(s):  
Kiwoong Yu ◽  
Cheolhwan Kim ◽  
Eunju Sung ◽  
Hocheol Shin ◽  
Hyewon Lee
Keyword(s):  
Total Bilirubin ◽  
High Sensitivity ◽  
Serum Total Bilirubin ◽  
C Reactive Protein ◽  
Middle Aged ◽  
Reactive Protein

scholarly journals A clinical corelation study of dengue fever with hepatic dysfunction in children and their outcome

2021 ◽  
Vol 8 (4) ◽  
pp. 706
Author(s):  
Srividya G. M. ◽  
Poornima Lakshmi
Keyword(s):  
Hepatic Dysfunction ◽  
Total Bilirubin ◽  
Complete Blood Count ◽  
Dengue Infection ◽  
Liver Function Tests ◽  
Significant Rise ◽  
Warning Signs ◽  
Severe Dengue ◽  
Serum Total Bilirubin ◽  
Life Threatening

Background: The study was hepatic dysfunction in childhood dengue infection and to study clinical co-relation like severity, clinical features, and outcome.Methods: Dengue sero positive patients of 100 were admitted during the study period and examined for hepatomegaly and jaundice and subjected to complete blood count, liver function tests, ultrasound abdomen, PT, APTT, HBsAg, HCV, Widal and analysed.Results: All patients presented with fever, most commonly occurred in age group of 5 to 7 years, hepatomegaly was the commonest clinical sign seen, thrombocytopenia was seen in 88% of cases, serum total bilirubin was raised in 10% of subjects with severe dengue infection. Serum SGOT was raised in 74 % of patients with dengue. When compared between the groups, rise in SGOT occurred in 74% of patients with probable dengue, 98% with warning signs and 100% in severe dengue. SGPT was raised in 58% of patients with dengue infection. When compared between the groups, rise in SGPT occurred in 42% of patients with probable dengue, 66% with warning signs and 81% in severe dengue. SGPT was raised in 28% of patients with dengue infection. When compared between the groups, rise in SGOT occurred in 9.5% of patients with probable dengue, 32% with warning signs and 82% in severe dengue. Prothrombin time was raised in 11% of patients. When compared between the groups, rise in PT occurred in 6.4% with warning signs and 72% in severe dengue. When compared between the groups, rise in APTT occurred in 6.4% of patients with warning signs and 72% in severe dengue. When compared between the groups fall in serum protein occurred in 12.7% with warning signs and 54.5% in severe dengue. 2 cases of severe dengue expired, in which the enzyme levels were highly elevated.Conclusions: Significant rise of liver enzymes helps in recognition of severe forms of dengue infection. As hepatic dysfunction in dengue is transient and reversible, early identification of the same should help to reduce life threatening complications. This can help to reduce the morbidity and mortality due to dengue infection.al population.  

Low serum total bilirubin concentrations are associated with increased prevalence of metabolic syndrome in Chinese

2011 ◽  
Vol 3 (3) ◽  
pp. 217-224 ◽  
Author(s):  
Yaohua WU ◽  
Mian LI ◽  
Min XU ◽  
Yufang BI ◽  
Xiaoying LI ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Total Bilirubin ◽  
Serum Total Bilirubin ◽  
Low Serum
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